Provider Demographics
NPI:1215469812
Name:CORZINE-MYERS, ALISHA MARIE (BCBA)
Entity type:Individual
Prefix:MS
First Name:ALISHA
Middle Name:MARIE
Last Name:CORZINE-MYERS
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:MS
Other - First Name:ALISHA
Other - Middle Name:MARIE
Other - Last Name:CORZINE SANDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BCABA
Mailing Address - Street 1:11424 FAIRWAYS AVE
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9760
Mailing Address - Country:US
Mailing Address - Phone:720-937-6692
Mailing Address - Fax:
Practice Address - Street 1:11424 FAIRWAYS AVE
Practice Address - Street 2:11424 FAIRWAYS AVE
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-9760
Practice Address - Country:US
Practice Address - Phone:720-937-6692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-01
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-18-32886103K00000X
TX0-17-7726106E00000X
OK1-18-32886103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst