Provider Demographics
NPI:1972212413
Name:RIPLEY, ALYSSA TAYLOR (BCBA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:TAYLOR
Last Name:RIPLEY
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 1:1060 WIGWAM PKWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-8162
Mailing Address - Country:US
Mailing Address - Phone:702-547-6971
Mailing Address - Fax:702-547-6948
Practice Address - Street 1:4350 E SUNSET RD STE 203
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-2260
Practice Address - Country:US
Practice Address - Phone:702-547-6971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-22
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV1-24-78688103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV250022641Medicaid
NV1-24-78688OtherBACB