Provider Demographics
NPI:1700388899
Name:RITTENHOUSE, ALEXIS JAMES (BCBA 1-17-28294)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:JAMES
Last Name:RITTENHOUSE
Suffix:
Gender:F
Credentials:BCBA 1-17-28294
Other - Prefix:
Other - First Name:ALEXIS
Other - Middle Name:
Other - Last Name:HEMINGWAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2405 PALMER CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6351
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2405 PALMER CIR STE 100
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6351
Practice Address - Country:US
Practice Address - Phone:405-561-7928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-17-28294103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst