Provider Demographics
NPI:1285154815
Name:ADAIR, ALICIA PAIGE (BCBA)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:PAIGE
Last Name:ADAIR
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:PAIGE
Other - Last Name:BIFFLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1466 WOOD TRAIL CIR
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016-6124
Mailing Address - Country:US
Mailing Address - Phone:901-463-0312
Mailing Address - Fax:
Practice Address - Street 1:1407 UNION AVE STE 1407
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38104-3680
Practice Address - Country:US
Practice Address - Phone:901-276-9606
Practice Address - Fax:901-276-9607
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-24
Last Update Date:2017-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-17-26623103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty