Provider Demographics
NPI:1194418228
Name:LANTER, ALEXANDRIA M (PHD BCBA)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:M
Last Name:LANTER
Suffix:
Gender:F
Credentials:PHD BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 AUTUMN WAY
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1794
Mailing Address - Country:US
Mailing Address - Phone:845-548-3073
Mailing Address - Fax:
Practice Address - Street 1:99 KINDERKAMACK RD STE 302
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07675-3020
Practice Address - Country:US
Practice Address - Phone:845-548-3073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-02
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1-19-37277103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst