Provider Demographics
NPI:1114749983
Name:SHERBAN, ISABELLA MARIE (MS, BCBA)
Entity type:Individual
Prefix:
First Name:ISABELLA
Middle Name:MARIE
Last Name:SHERBAN
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2246 S ROCKHILL AVE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-4712
Mailing Address - Country:US
Mailing Address - Phone:330-614-2988
Mailing Address - Fax:
Practice Address - Street 1:95 EXECUTIVE PKWY
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44236-1699
Practice Address - Country:US
Practice Address - Phone:330-655-0946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-31
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-24-76472103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst