Provider Demographics
NPI:1194379586
Name:GEORGE, ALANA HEAVEN
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:HEAVEN
Last Name:GEORGE
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 1:5330 YACHT HAVEN GRANDE STE 201
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00802-5028
Mailing Address - Country:US
Mailing Address - Phone:340-719-7007
Mailing Address - Fax:
Practice Address - Street 1:5330 YACHT HAVEN GRANDE STE 201
Practice Address - Street 2:
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-5028
Practice Address - Country:US
Practice Address - Phone:340-719-6655
Practice Address - Fax:340-719-6655
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-24
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
FL1-23-69193103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician