Provider Demographics
NPI:1306368873
Name:HAND, ELIZABETH ANN (RBT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:HAND
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:DRAGOO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BETSY ANN DRAGOO
Mailing Address - Street 1:PO BOX 30958
Mailing Address - Street 2:
Mailing Address - City:ANAHOLA
Mailing Address - State:HI
Mailing Address - Zip Code:96703-0958
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6201 ALTA MONTE AVE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-2101
Practice Address - Country:US
Practice Address - Phone:404-780-3242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-16
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-20-124245106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician