Provider Demographics
NPI:1801131735
Name:MCALLISTER, LAUREN RAE (BCABA)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:RAE
Last Name:MCALLISTER
Suffix:
Gender:F
Credentials:BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MERWICK RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5730
Mailing Address - Country:US
Mailing Address - Phone:609-987-0099
Mailing Address - Fax:609-454-4886
Practice Address - Street 1:2 MERWICK RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5730
Practice Address - Country:US
Practice Address - Phone:609-987-0099
Practice Address - Fax:609-454-4886
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ0-17-7994106E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ12466127OtherCAQH