Provider Demographics
NPI:1811518558
Name:NEWTON, ELIJAH EZRA (RBT)
Entity type:Individual
Prefix:
First Name:ELIJAH
Middle Name:EZRA
Last Name:NEWTON
Suffix:
Gender:M
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8181 COMMERCE PARK DR STE 726
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7449
Mailing Address - Country:US
Mailing Address - Phone:346-217-8328
Mailing Address - Fax:
Practice Address - Street 1:8181 COMMERCE PARK DR STE 726
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7449
Practice Address - Country:US
Practice Address - Phone:346-217-8328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-05
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBACB478796106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician