Provider Demographics
NPI:1336739952
Name:CRIST, ELIZABETH SCOUTE (RBT)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SCOUTE
Last Name:CRIST
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-1046 PAHA PL APT P4
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4224
Mailing Address - Country:US
Mailing Address - Phone:530-643-1308
Mailing Address - Fax:
Practice Address - Street 1:94-1046 PAHA PL APT P4
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4224
Practice Address - Country:US
Practice Address - Phone:530-643-1308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-19
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRBT-20-143934106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician