Provider Demographics
NPI:1235628348
Name:PATTERSON, ALLYSON (BCBA-D, LBA)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:PATTERSON
Suffix:
Gender:F
Credentials:BCBA-D, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4342 4TH ST N
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22203-3068
Mailing Address - Country:US
Mailing Address - Phone:571-317-1446
Mailing Address - Fax:
Practice Address - Street 1:4342 4TH ST N
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22203-3068
Practice Address - Country:US
Practice Address - Phone:571-317-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-03
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001138103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
14252223OtherCAQH PROVIDER ID