Provider Demographics
NPI:1699585430
Name:D'ABBRACCIO, ANITA LOUISE (BCBA)
Entity type:Individual
Prefix:
First Name:ANITA
Middle Name:LOUISE
Last Name:D'ABBRACCIO
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 QUEENS CT
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-3633
Mailing Address - Country:US
Mailing Address - Phone:414-745-6277
Mailing Address - Fax:
Practice Address - Street 1:29 QUEENS CT
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-3633
Practice Address - Country:US
Practice Address - Phone:414-745-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1254-140103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst