Provider Demographics
NPI:1912374422
Name:ZEPPERNICK, ELIZABETH
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ZEPPERNICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:ZEPPERNICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BCBA
Mailing Address - Street 1:5 RIVER RD
Mailing Address - Street 2:SUITE 142
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4069
Mailing Address - Country:US
Mailing Address - Phone:917-434-7459
Mailing Address - Fax:888-761-5161
Practice Address - Street 1:5 RIVER RD
Practice Address - Street 2:SUITE 142
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897-4069
Practice Address - Country:US
Practice Address - Phone:917-434-7459
Practice Address - Fax:888-761-5161
Is Sole Proprietor?:No
Enumeration Date:2015-09-01
Last Update Date:2015-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1106720103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst