Provider Demographics
NPI:1194358226
Name:BALZAROTTI, ALYSSA (BCBA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:BALZAROTTI
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 ATLAS RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2206
Mailing Address - Country:US
Mailing Address - Phone:973-610-9410
Mailing Address - Fax:
Practice Address - Street 1:1071 VALLEY RD
Practice Address - Street 2:
Practice Address - City:STIRLING
Practice Address - State:NJ
Practice Address - Zip Code:07980-1523
Practice Address - Country:US
Practice Address - Phone:908-604-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-23-68247103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst