Provider Demographics
NPI:1316481476
Name:PARENT, ALISON SANFACON (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:SANFACON
Last Name:PARENT
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1312
Mailing Address - Country:US
Mailing Address - Phone:603-234-5935
Mailing Address - Fax:
Practice Address - Street 1:4 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1312
Practice Address - Country:US
Practice Address - Phone:603-234-5935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000718-1103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst