Provider Demographics
NPI:1700329547
Name:COWART, BETHANY (BCBA)
Entity Type:Individual
Prefix:
First Name:BETHANY
Middle Name:
Last Name:COWART
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3258 RINGLE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:MI
Mailing Address - Zip Code:48701-9519
Mailing Address - Country:US
Mailing Address - Phone:899-737-4840
Mailing Address - Fax:
Practice Address - Street 1:3258 RINGLE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:MI
Practice Address - Zip Code:48701-9519
Practice Address - Country:US
Practice Address - Phone:899-737-4840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst