Provider Demographics
NPI:1205073210
Name:NELSON, LANA BECNEL (BCABA)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:BECNEL
Last Name:NELSON
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W WALNUT ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3316
Mailing Address - Country:US
Mailing Address - Phone:479-802-4798
Mailing Address - Fax:
Practice Address - Street 1:1310 W WALNUT ST
Practice Address - Street 2:SUITE A
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3316
Practice Address - Country:US
Practice Address - Phone:479-802-4798
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
0-08-2651OtherBACB