Provider Demographics
NPI:1053824250
Name:REA, ALLISON SHEATS (BCBA)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:SHEATS
Last Name:REA
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 1:1710 MOORES LN
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-1858
Mailing Address - Country:US
Mailing Address - Phone:903-794-2705
Mailing Address - Fax:903-793-1203
Practice Address - Street 1:1710 MOORES LN
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1858
Practice Address - Country:US
Practice Address - Phone:903-794-2705
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-09
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-17-26994103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst