Provider Demographics
NPI:1578218939
Name:ADAMS-OLSEN, ALEXIS MICHELLE (BCBA)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:MICHELLE
Last Name:ADAMS-OLSEN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:MICHELLE
Other - Last Name:OLSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BCBA
Mailing Address - Street 1:1117 GRINNELL RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-5125
Mailing Address - Country:US
Mailing Address - Phone:302-660-1876
Mailing Address - Fax:
Practice Address - Street 1:1405 FOULK RD STE 100
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-2769
Practice Address - Country:US
Practice Address - Phone:877-222-0399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1-22-57818103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst