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NPI Code Detail

MEDICARE: ALLYSON PATTERSON BCBA-D, LBA

MEDICARE: ALLYSON PATTERSON BCBA-D, LBA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst0133001138VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
114252223OTHERCAQH PROVIDER ID

General Provider Information

NPI Number : 1235628348
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLYSON PATTERSON BCBA-D, LBA
Provider Business Mailing Address
First Line : 4342 4TH ST N
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-3068
Country : US
Telephone Number : 571-317-1446
Fax Number :
Provider Business Practice Location Address
First Line : 4342 4TH ST N
Second Line :
City : ARLINGTON
State : VA
Zip : 22203-3068
Country : US
Telephone Number : 571-317-1446
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2018
Last Update Date : 03/12/2026

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