Provider Demographics
NPI:1043681398
Name:CRIFT, RESHANAE L (BCBA)
Entity type:Individual
Prefix:
First Name:RESHANAE
Middle Name:L
Last Name:CRIFT
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 1:16401 CHENAL VALLEY DR APT 2307
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-3928
Mailing Address - Country:US
Mailing Address - Phone:870-723-3514
Mailing Address - Fax:
Practice Address - Street 1:435 GREENE 773 RD
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-9638
Practice Address - Country:US
Practice Address - Phone:870-568-5195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1-21-47669103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst