Provider Demographics
NPI:1528217312
Name:ALI, ELENA MARIE (MSED, BCBA, LBA)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:MARIE
Last Name:ALI
Suffix:
Gender:F
Credentials:MSED, BCBA, LBA
Other - Prefix:
Other - First Name:ELENA
Other - Middle Name:MARIE
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:908 SALISBURY GRN
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-6123
Mailing Address - Country:US
Mailing Address - Phone:757-406-7397
Mailing Address - Fax:
Practice Address - Street 1:908 SALISBURY GRN
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-6123
Practice Address - Country:US
Practice Address - Phone:757-406-7397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0133001900103K00000X
MDLBA752103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst