Provider Demographics
NPI:1427724814
Name:VENTRICE, ALLISON L (MED, BCBA)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:L
Last Name:VENTRICE
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HOMER SQ # 2
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02143-3003
Mailing Address - Country:US
Mailing Address - Phone:604-540-0811
Mailing Address - Fax:
Practice Address - Street 1:610 LINCOLN ST STE 120
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-2188
Practice Address - Country:US
Practice Address - Phone:781-760-1539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-17
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst