Provider Demographics
NPI:1861293623
Name:DEATON, ABBIE LYNN (MS BCBA)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:LYNN
Last Name:DEATON
Suffix:
Gender:F
Credentials:MS BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 ELMORE AVE
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2594
Mailing Address - Country:US
Mailing Address - Phone:815-912-2551
Mailing Address - Fax:815-912-2551
Practice Address - Street 1:3402 ELMORE AVE
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2594
Practice Address - Country:US
Practice Address - Phone:815-912-2551
Practice Address - Fax:815-912-2551
Is Sole Proprietor?:No
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-25-79957103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst