Provider Demographics
NPI:1962745075
Name:SHEPPARD, ALLISON NOEL (BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:NOEL
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:MRS
Other - First Name:ALLISON
Other - Middle Name:NOEL
Other - Last Name:FEDORKA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:1557 ULUHAO ST
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-4422
Mailing Address - Country:US
Mailing Address - Phone:808-386-0331
Mailing Address - Fax:
Practice Address - Street 1:2226 LILIHA ST STE 403
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1605
Practice Address - Country:US
Practice Address - Phone:808-638-1882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2019-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIBA297103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst