Provider Demographics
NPI:1629584867
Name:LARSON, ALEXANDRIA (BCBA)
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:
Last Name:LARSON
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 1:407 GLENN AVE
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6109
Mailing Address - Country:US
Mailing Address - Phone:703-506-0123
Mailing Address - Fax:
Practice Address - Street 1:801 BIRCHFIELD DR
Practice Address - Street 2:
Practice Address - City:MT. LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054
Practice Address - Country:US
Practice Address - Phone:484-681-2170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-26
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician