=====================================================
General NPI Number Information
=====================================================
NPI Number | 1316751605
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALIANSA BEHAVIOR CONSULTING LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2025
-----------------------------------------------------
Last Update Date | 02/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2429 W HOLT AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53215-4825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-407-9172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2429 W HOLT AVE
-----------------------------------------------------
City | MILWAUKEE
-----------------------------------------------------
State | WI
-----------------------------------------------------
Zip | 53215-4825
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-407-9172
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANNA R GARCIA
-----------------------------------------------------
Credential | PH.D., BCBA
-----------------------------------------------------
Telephone | 813-407-9172
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------