Provider Demographics
NPI:1780083212
Name:HINER, BETHANY LYN (BCBA)
Entity type:Individual
Prefix:MRS
First Name:BETHANY
Middle Name:LYN
Last Name:HINER
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 1:1211 DESTINY CT
Mailing Address - Street 2:
Mailing Address - City:WYLIE
Mailing Address - State:TX
Mailing Address - Zip Code:75098-5188
Mailing Address - Country:US
Mailing Address - Phone:214-403-1182
Mailing Address - Fax:
Practice Address - Street 1:911 N GOLIAD ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-2230
Practice Address - Country:US
Practice Address - Phone:469-458-9021
Practice Address - Fax:866-693-6509
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-20
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
TX1-21-49670103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist