Provider Demographics
NPI:1619564366
Name:RHEA, ELISABETH (BCBA)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:RHEA
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 1:1880 S UNION AVE STE C
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AL
Mailing Address - Zip Code:36360-2944
Mailing Address - Country:US
Mailing Address - Phone:334-443-1043
Mailing Address - Fax:
Practice Address - Street 1:1880 S UNION AVE STE C
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-2944
Practice Address - Country:US
Practice Address - Phone:334-443-1043
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALRBT-19-88609106S00000X
1-21-553090103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician