Provider Demographics
NPI:1568077832
Name:DOYLE, ALISSA DIANA (BCBA)
Entity Type:Individual
Prefix:
First Name:ALISSA
Middle Name:DIANA
Last Name:DOYLE
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 SE 5TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5265
Mailing Address - Country:US
Mailing Address - Phone:862-400-0973
Mailing Address - Fax:
Practice Address - Street 1:1239 E NEWPORT CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-7711
Practice Address - Country:US
Practice Address - Phone:754-444-3707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-13
Last Update Date:2020-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst