Provider Demographics
NPI:1164964847
Name:DEPALMA, ALLISON ROSE (BCBA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ROSE
Last Name:DEPALMA
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 1:18419 EASTWYCK DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3176
Mailing Address - Country:US
Mailing Address - Phone:813-368-0973
Mailing Address - Fax:
Practice Address - Street 1:18419 EASTWYCK DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3176
Practice Address - Country:US
Practice Address - Phone:813-368-0973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLFLORIDAMedicaid