Healthcare Provider Details

I. General information

NPI: 1194426270
Provider Name (Legal Business Name): ALLISON LEMAIRE LY RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2023
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LONG CREEK LN
RICHMOND HILL GA
31324-8601
US

IV. Provider business mailing address

130 CORRIDOR RD UNIT 3292
PONTE VEDRA BEACH FL
32004-7833
US

V. Phone/Fax

Practice location:
  • Phone: 904-638-6388
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number0-25-16662
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: