Provider Demographics
NPI:1871489161
Name:ALARID, ALLY CLAIRE
Entity type:Individual
Prefix:
First Name:ALLY
Middle Name:CLAIRE
Last Name:ALARID
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:ALLY
Other - Middle Name:CLAIRE
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1649 61ST ST FL 3013
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-2110
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:15 MCGUIRE DR E
Practice Address - Street 2:
Practice Address - City:IOLA
Practice Address - State:KS
Practice Address - Zip Code:66749-7200
Practice Address - Country:US
Practice Address - Phone:620-228-1785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-14
Last Update Date:2025-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSK03-88-9042106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician