Provider Demographics
NPI:1063851012
Name:FAGNANO, ALI CHRISTINE (ABA)
Entity type:Individual
Prefix:MS
First Name:ALI
Middle Name:CHRISTINE
Last Name:FAGNANO
Suffix:
Gender:F
Credentials:ABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1145 LOGAN WOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-3324
Mailing Address - Country:US
Mailing Address - Phone:330-356-0725
Mailing Address - Fax:
Practice Address - Street 1:1145 LOGAN WOOD DR
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-3324
Practice Address - Country:US
Practice Address - Phone:330-356-0725
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst