Provider Demographics
NPI:1164912713
Name:HESTER, ELISE K (MA ABA)
Entity type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:K
Last Name:HESTER
Suffix:
Gender:F
Credentials:MA ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8922 CUMING ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2732
Mailing Address - Country:US
Mailing Address - Phone:402-926-4373
Mailing Address - Fax:
Practice Address - Street 1:601 6TH ST
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-1995
Practice Address - Country:US
Practice Address - Phone:810-202-2266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7401000762103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst