Provider Demographics
NPI:1982160255
Name:HENDRIX, ELIZABETH NICOLE (MS, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:NICOLE
Last Name:HENDRIX
Suffix:
Gender:F
Credentials:MS, BCBA, LBA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:NICOLE
Other - Last Name:GREGORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7010 E ACOMA DR STE 101H
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3550
Mailing Address - Country:US
Mailing Address - Phone:480-999-5666
Mailing Address - Fax:
Practice Address - Street 1:7010 E ACOMA DR STE 101H
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3550
Practice Address - Country:US
Practice Address - Phone:408-999-5666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2022-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0-17-7873106E00000X
AZBEH-000805103K00000X
CA1-20-40611103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst