Provider Demographics
NPI:1689195612
Name:SLOAN, ELIZABETH KATHERINE (BCBA, LABA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KATHERINE
Last Name:SLOAN
Suffix:
Gender:F
Credentials:BCBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 AUBURN ST APT 11
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-4849
Mailing Address - Country:US
Mailing Address - Phone:508-808-1589
Mailing Address - Fax:
Practice Address - Street 1:45 AUBURN STREET, APT 11
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701
Practice Address - Country:US
Practice Address - Phone:508-808-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1732103K00000X
1-16-22602103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst