Provider Demographics
NPI:1801209135
Name:EBY, CHRISTINA ELIZABETH (BCBA)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:ELIZABETH
Last Name:EBY
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:300 INTERNATIONAL PKWY STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5028
Mailing Address - Country:US
Mailing Address - Phone:866-610-0580
Mailing Address - Fax:407-588-6294
Practice Address - Street 1:6385 MCGINNIS FERRY RD STE 202
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-3672
Practice Address - Country:US
Practice Address - Phone:470-508-9575
Practice Address - Fax:470-408-2692
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1-18-30788103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst