Provider Demographics
NPI:1760067755
Name:KOHL, ALI (BCBA)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:KOHL
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 1:10797 TALISMAN DR
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-7630
Mailing Address - Country:US
Mailing Address - Phone:317-361-7733
Mailing Address - Fax:
Practice Address - Street 1:10797 TALISMAN DR
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-7630
Practice Address - Country:US
Practice Address - Phone:317-361-7733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-11
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst