Individual
JUDITH ELISE BEEBOUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
719 SPENCER ST, LOGANSPORT, IN 46947-3583
(317) 762-2917
Mailing address
719 SPENCER ST, LOGANSPORT, IN 46947-3583
(317) 762-2917
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BACB770381
BEHAVIOR ANALYST CERTIFICATION
IN
Enumeration date
03/11/2022
Last updated
09/14/2023
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