Healthcare Provider Details

I. General information

NPI: 1417436346
Provider Name (Legal Business Name): ALISON MARIE SPRAGUE MA,BCBA,LBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18156 W H 40
RUDYARD MI
49780-9216
US

IV. Provider business mailing address

18156 W H 40
RUDYARD MI
49780-9216
US

V. Phone/Fax

Practice location:
  • Phone: 906-430-8829
  • Fax:
Mailing address:
  • Phone: 906-430-8829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number7401003342
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: