Provider Demographics
NPI:1386999530
Name:TOMEI, ALEXANDRA DIANNE (LBA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:DIANNE
Last Name:TOMEI
Suffix:
Gender:F
Credentials:LBA, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30875 SR 20
Mailing Address - Street 2:B-1
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-7534
Mailing Address - Country:US
Mailing Address - Phone:360-600-0177
Mailing Address - Fax:
Practice Address - Street 1:31955 SR 20
Practice Address - Street 2:SUITE 3
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-5211
Practice Address - Country:US
Practice Address - Phone:360-279-9000
Practice Address - Fax:180-099-1607
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-14-17142103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
WABA60767196OtherWASHINGTON DOH
CO1-14-17142OtherBEHAVIOR ANALYST CERTIFICATION BOARD
VA0133000817OtherVIRGINIA DOH