Provider Demographics
NPI:1588391254
Name:MACGRATH, ALANNA B (RBT)
Entity type:Individual
Prefix:
First Name:ALANNA
Middle Name:B
Last Name:MACGRATH
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 N CARIBE AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-1256
Mailing Address - Country:US
Mailing Address - Phone:520-991-8299
Mailing Address - Fax:
Practice Address - Street 1:2230 E PRINCE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-2002
Practice Address - Country:US
Practice Address - Phone:520-461-7550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRBT-22-219557106S00000X
AZ106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty