Provider Demographics
NPI:1467710129
Name:PRINCE-ALCE, FABIENNE (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:FABIENNE
Middle Name:
Last Name:PRINCE-ALCE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:FABIENNE
Other - Middle Name:
Other - Last Name:PRINCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 MORELAND ST
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01609-1041
Mailing Address - Country:US
Mailing Address - Phone:203-273-0441
Mailing Address - Fax:
Practice Address - Street 1:17 MORELAND ST
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01609-1041
Practice Address - Country:US
Practice Address - Phone:203-273-0441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 222Q00000X
MA2555103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist