Provider Demographics
NPI:1548523525
Name:REID, ALLISON ERICA (MA, BCBA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:ERICA
Last Name:REID
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14385 TYLER AVE
Mailing Address - Street 2:
Mailing Address - City:BECKER
Mailing Address - State:MN
Mailing Address - Zip Code:55308-8852
Mailing Address - Country:US
Mailing Address - Phone:502-593-7511
Mailing Address - Fax:
Practice Address - Street 1:14385 TYLER AVENUE
Practice Address - Street 2:
Practice Address - City:BECKER
Practice Address - State:MN
Practice Address - Zip Code:55308
Practice Address - Country:US
Practice Address - Phone:502-593-7511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-24
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst