Provider Demographics
NPI:1417637505
Name:HOLDER, ALLISON (BCBA, NC LBA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:HOLDER
Suffix:
Gender:F
Credentials:BCBA, NC LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PARK FORTY PLZ STE 110
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-5249
Mailing Address - Country:US
Mailing Address - Phone:919-480-2800
Mailing Address - Fax:
Practice Address - Street 1:1000 PARK FORTY PLZ STE 110
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-5249
Practice Address - Country:US
Practice Address - Phone:919-480-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NC965103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst