Provider Demographics
NPI:1346010972
Name:ARNOLD-HARRIS, ELIZABETH (RBT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ARNOLD-HARRIS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-4718
Mailing Address - Country:US
Mailing Address - Phone:731-420-6997
Mailing Address - Fax:
Practice Address - Street 1:1119 OLD HUMBOLDT RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38305-1752
Practice Address - Country:US
Practice Address - Phone:731-613-1721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician