Provider Demographics
NPI:1407138126
Name:BEEN, ELIZABETH ANN
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:BEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 60 BOX 71A
Mailing Address - Street 2:
Mailing Address - City:CASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:74833-9712
Mailing Address - Country:US
Mailing Address - Phone:918-623-6723
Mailing Address - Fax:
Practice Address - Street 1:HC 60 BOX 71A
Practice Address - Street 2:
Practice Address - City:CASTLE
Practice Address - State:OK
Practice Address - Zip Code:74833-9712
Practice Address - Country:US
Practice Address - Phone:918-623-6723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst