Provider Demographics
NPI:1154875706
Name:HARRIS, ALYSSA (MA BCBA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA BCBA
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:STRANZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1215 WAR EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38572-9009
Mailing Address - Country:US
Mailing Address - Phone:931-287-3710
Mailing Address - Fax:931-287-2778
Practice Address - Street 1:1215 WAR EAGLE DR
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38572-9009
Practice Address - Country:US
Practice Address - Phone:931-287-3710
Practice Address - Fax:931-287-2778
Is Sole Proprietor?:No
Enumeration Date:2016-08-12
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-16-22631103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1-16-22631OtherBCBA LICENSE