Individual
ELIZABETH JANICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, BCBA, LBA
Contact information
Practice address
491 KILVERT ST, WARWICK, RI 02886-1370
(401) 618-6991
Mailing address
13 N PRECINCT ST, LAKEVILLE, MA 02347-1217
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
LABA2763
MA
103K00000X
Behavior Analyst
Primary
LBA00154
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-18-32291
BCBA
—
01
—
LABA2763
LABA
MA
01
—
LBA00154
LBA
RI
Enumeration date
10/15/2018
Last updated
07/24/2024
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