# ELIZABETH ROSE TIBERG

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1518585678
- **Gender:** F
- **Credential:** MED, BCBA, COBA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | 1-20-42623 | IN | — |
| 103K00000X | Behavior Analyst | — | NULL | Yes |

## Other

- **Enumeration date:** 07/06/2020
- **Last updated:** 10/12/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1-20-42623 | BCBA CERTIFICATE | — |