Provider Demographics
NPI:1972805174
Name:MCTIERNAN, ELIZABETH RACHEL (BCABA)
Entity Type:Individual
Prefix:MISS
First Name:ELIZABETH
Middle Name:RACHEL
Last Name:MCTIERNAN
Suffix:
Gender:F
Credentials:BCABA
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Mailing Address - Street 1:280 INTERSTATE NORTH CIR SE
Mailing Address - Street 2:SUITE 430
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-2450
Mailing Address - Country:US
Mailing Address - Phone:770-956-8511
Mailing Address - Fax:770-956-8907
Practice Address - Street 1:280 INTERSTATE NORTH CIR SE
Practice Address - Street 2:SUITE 430
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2450
Practice Address - Country:US
Practice Address - Phone:770-956-8511
Practice Address - Fax:770-956-8907
Is Sole Proprietor?:No
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0-10-3961103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst