NPI 1104599257 · live from the CMS NPI Registry
Alyssa Nicole Bourque
Behavior Analyst in Slocomb, AL. National Provider Identifier 1104599257, active.
NPI record
| NPI | 1104599257 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Behavior Analyst 103K00000X |
| Practice location | 612 S Watford Rd, Slocomb, AL 36375 |
| Practice phone | 334-258-5482 |
| Enumerated | July 26, 2021 |
| Last updated | July 26, 2021 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Behavior Analyst primary | 103K00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.