Provider Demographics
NPI:1366736233
Name:O'CONNOR, ALISON STOTHARD (PSYD, BCBA)
Entity type:Individual
Prefix:DR
First Name:ALISON
Middle Name:STOTHARD
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PSYD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 SECOND AVE # 6
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5952
Mailing Address - Country:US
Mailing Address - Phone:201-214-7532
Mailing Address - Fax:
Practice Address - Street 1:815 CEDARBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4933
Practice Address - Country:US
Practice Address - Phone:732-363-3335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00632000103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical