MEDICARE: ALLISON S HARNOIS RBT

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
1	106S00000X	Behavior Technician		VA
2	103K00000X	Behavior Analyst	1-25-80066	VA

General Provider Information

NPI Number	:	1376134486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON S HARNOIS RBT

Provider Business Mailing Address
First Line	:	429 CAROLINA AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-4604
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	429 CAROLINA AVE
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23451-4604
Country	:	US
Telephone Number	:	757-561-5386
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/01/2021
Last Update Date	:	03/28/2025

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