Provider Demographics
NPI:1891594123
Name:HERRLIN, ALEXANDRA (BCBA)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:HERRLIN
Suffix:
Gender:
Credentials:BCBA
Other - Prefix:
Other - First Name:ADDIE
Other - Middle Name:
Other - Last Name:HERRLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:30 PARK OF COMMERCE WAY # 100
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-1358
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:30 PARK OF COMMERCE WAY # 100
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-1358
Practice Address - Country:US
Practice Address - Phone:800-844-1232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-25-79826103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst