Provider Demographics
NPI:1548958200
Name:ALLISON'S THERAPY CORNER
Entity type:Organization
Organization Name:ALLISON'S THERAPY CORNER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED BEHAVIORAL TECHNICIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BUFORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-444-0556
Mailing Address - Street 1:1316 N CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1034
Mailing Address - Country:US
Mailing Address - Phone:682-444-0556
Mailing Address - Fax:
Practice Address - Street 1:4917 GOLDEN TRIANGLE BLVD STE 411
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76244-4480
Practice Address - Country:US
Practice Address - Phone:817-734-6515
Practice Address - Fax:817-717-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty