Provider Demographics
NPI:1619516861
Name:ALLGOOD, ALLISON MARIE (MED, BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:ALLGOOD
Suffix:
Gender:F
Credentials:MED, BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2716 WHEATON DR
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47725-6711
Mailing Address - Country:US
Mailing Address - Phone:812-319-7885
Mailing Address - Fax:
Practice Address - Street 1:2716 WHEATON DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47725-6711
Practice Address - Country:US
Practice Address - Phone:812-319-4151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-04
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY262451103K00000X
1-19-39966103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-19-39966OtherBCBA CERTIFICATE