Individual
ELIZABETH BACIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9559 HIGHWAY 5 STE 601, DOUGLASVILLE, GA 30135-1572
(470) 632-5276
(317) 520-8200
Mailing address
3500 DEPAUW BLVD STE 3070, INDIANAPOLIS, IN 46268-6135
(855) 324-0885
(317) 520-8200
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-22-60833
GA
106S00000X
Behavior Technician
RBT-19-84634
NC
Other
Enumeration date
04/22/2019
Last updated
08/16/2022
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