Provider Demographics
NPI:1760150759
Name:UTESCH, ELIZABETH (BCBA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:UTESCH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3111 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-8342
Mailing Address - Country:US
Mailing Address - Phone:206-552-6724
Mailing Address - Fax:206-456-1889
Practice Address - Street 1:12826 SE 40TH LN
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-4278
Practice Address - Country:US
Practice Address - Phone:206-552-6724
Practice Address - Fax:206-456-1889
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst