Provider Demographics
NPI:1053907048
Name:THOMAS SCUDDER, JULIET ELIZABETH (BCBA)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:ELIZABETH
Last Name:THOMAS SCUDDER
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:296 BEAUVOIR RD STE 100-1311
Mailing Address - Street 2:
Mailing Address - City:BILOXI
Mailing Address - State:MS
Mailing Address - Zip Code:39531-4051
Mailing Address - Country:US
Mailing Address - Phone:985-778-7553
Mailing Address - Fax:850-607-6932
Practice Address - Street 1:296 BEAUVOIR RD STE 100-1311
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39531-4051
Practice Address - Country:US
Practice Address - Phone:985-778-7553
Practice Address - Fax:850-607-6932
Is Sole Proprietor?:No
Enumeration Date:2020-12-15
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician