Provider Demographics
NPI:1578075792
Name:ALSTON, JAMESA YVETTE (MS,BCBA)
Entity Type:Individual
Prefix:
First Name:JAMESA
Middle Name:YVETTE
Last Name:ALSTON
Suffix:
Gender:F
Credentials:MS,BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2068 EVELYN AVE
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38104-5416
Mailing Address - Country:US
Mailing Address - Phone:731-234-1873
Mailing Address - Fax:
Practice Address - Street 1:6830 GARMIN LN
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-8850
Practice Address - Country:US
Practice Address - Phone:901-277-3318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-27
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
TN802103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician