Provider Demographics
NPI:1467572297
Name:LABRIE, ALLISON C (EDD, BCBA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:C
Last Name:LABRIE
Suffix:
Gender:F
Credentials:EDD, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12813 US HIGHWAY 24 W
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46814-7447
Mailing Address - Country:US
Mailing Address - Phone:317-752-8185
Mailing Address - Fax:
Practice Address - Street 1:12813 US HIGHWAY 24 W
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46814-7447
Practice Address - Country:US
Practice Address - Phone:317-752-8185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist