Provider Demographics
NPI:1740704964
Name:WARREN, ELIZABETH K (BCBA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:WARREN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2082 S OVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LECANTO
Mailing Address - State:FL
Mailing Address - Zip Code:34461
Mailing Address - Country:US
Mailing Address - Phone:352-697-2879
Mailing Address - Fax:
Practice Address - Street 1:2082 S OVERVIEW DR
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8845
Practice Address - Country:US
Practice Address - Phone:352-697-2879
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-15-19538103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1952628059OtherDEBORAH L. MCCOY BEHAVIOR ANALYST, INC.