Provider Demographics
NPI:1992344501
Name:MEMENTOWSKI, ALAIA (BCBA, COBA)
Entity type:Individual
Prefix:MRS
First Name:ALAIA
Middle Name:
Last Name:MEMENTOWSKI
Suffix:
Gender:F
Credentials:BCBA, COBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27991 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3902
Mailing Address - Country:US
Mailing Address - Phone:440-455-3230
Mailing Address - Fax:
Practice Address - Street 1:27991 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-3902
Practice Address - Country:US
Practice Address - Phone:440-455-3230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-30
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1-21-50928103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst