Healthcare Provider Details

I. General information

NPI: 1679419931
Provider Name (Legal Business Name): LINA ALI BCBA, COBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6096 E MAIN ST STE 112
COLUMBUS OH
43213-4302
US

IV. Provider business mailing address

230 E LONG ST APT 358
COLUMBUS OH
43215-3342
US

V. Phone/Fax

Practice location:
  • Phone: 888-830-1672
  • Fax: 732-982-2626
Mailing address:
  • Phone: 347-356-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberCOBA.01934
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: