Healthcare Provider Details
I. General information
NPI: 1689156903
Provider Name (Legal Business Name): ALANA ANN ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/04/2018
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
35 WALNUT ST
WELLESLEY MA
02481-2101
US
IV. Provider business mailing address
4620 N STATE ROAD 7 STE 300
LAUDERDALE LAKES FL
33319-5867
US
V. Phone/Fax
- Phone: 877-889-1312
- Fax:
- Phone: 561-323-6598
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103K00000X |
| Taxonomy | Behavior Analyst |
| License Number | 3790 |
| License Number State | MA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: