Healthcare Provider Details

I. General information

NPI: 1639629728
Provider Name (Legal Business Name): ALLISON KAYSER BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2016
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9037 STELLHORN CROSSING PKWY
FORT WAYNE IN
46815-5860
US

IV. Provider business mailing address

517 GORDON AVE
VAN WERT OH
45891-2338
US

V. Phone/Fax

Practice location:
  • Phone: 260-338-1241
  • Fax:
Mailing address:
  • Phone: 269-303-5931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: