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NPI Code Detail

MEDICARE: ALISHA PEARL FLANAGAN BCBA, LBA

MEDICARE: ALISHA PEARL FLANAGAN BCBA, 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 Analyst2831-MH-B1MA
2103K00000XBehavior Analyst1759TN

General Provider Information

NPI Number : 1386289544
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISHA PEARL FLANAGAN BCBA, LBA
Provider Business Mailing Address
First Line : 3500 DEPAUW BLVD STE 3070
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46268-6135
Country : US
Telephone Number : 855-324-0885
Fax Number : 317-520-8200
Provider Business Practice Location Address
First Line : 7007 STAGE RD
Second Line :
City : MEMPHIS
State : TN
Zip : 38133-4977
Country : US
Telephone Number : 901-677-0422
Fax Number : 317-520-8200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/12/2019
Last Update Date : 02/03/2025

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