Provider Demographics
NPI:1457781478
Name:MORRISON, ALISA (MS, BCBA)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:
Last Name:MORRISON
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 WOODSIDE DR
Mailing Address - Street 2:STE 1
Mailing Address - City:CEDARBURG
Mailing Address - State:WI
Mailing Address - Zip Code:53012-9553
Mailing Address - Country:US
Mailing Address - Phone:262-365-9063
Mailing Address - Fax:262-922-4444
Practice Address - Street 1:388 WOODSIDE DR
Practice Address - Street 2:STE 1
Practice Address - City:CEDARBURG
Practice Address - State:WI
Practice Address - Zip Code:53012-9553
Practice Address - Country:US
Practice Address - Phone:262-365-9063
Practice Address - Fax:262-922-4444
Is Sole Proprietor?:No
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI72-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst