Provider Demographics
NPI:1104217108
Name:BERNSTEIN, ALLISON DRAKE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:DRAKE
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 HIGHTOWER TRL BLDG B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-6244
Mailing Address - Country:US
Mailing Address - Phone:770-355-3370
Mailing Address - Fax:
Practice Address - Street 1:1215 HIGHTOWER TRL BLDG B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30350-6244
Practice Address - Country:US
Practice Address - Phone:770-355-3370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-11
Last Update Date:2018-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst