Provider Demographics
NPI:1184983033
Name:HUSBAND, BETH M (BCBA)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:M
Last Name:HUSBAND
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1365 HOLLY TREE GAP RD
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-6408
Mailing Address - Country:US
Mailing Address - Phone:615-594-5392
Mailing Address - Fax:615-810-9939
Practice Address - Street 1:1365 HOLLY TREE GAP RD
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-6408
Practice Address - Country:US
Practice Address - Phone:615-594-5392
Practice Address - Fax:615-810-9939
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-13
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-03-1345103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst