# JUDITH ELISE BEEBOUT

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1699423475
- **Gender:** F
- **Credential:** BCBA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103K00000X | Behavior Analyst | — | NULL | Yes |

## Other

- **Enumeration date:** 03/11/2022
- **Last updated:** 09/14/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | BACB770381 | BEHAVIOR ANALYST CERTIFICATION | IN |