Provider Demographics
NPI:1295506517
Name:AHKAO, IVERIANA (BCBA, LBA)
Entity type:Individual
Prefix:
First Name:IVERIANA
Middle Name:
Last Name:AHKAO
Suffix:
Gender:F
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 KATHLEEN CT
Mailing Address - Street 2:
Mailing Address - City:KIAMESHA LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:12751-5037
Mailing Address - Country:US
Mailing Address - Phone:845-313-4820
Mailing Address - Fax:
Practice Address - Street 1:4 KATHLEEN CT
Practice Address - Street 2:
Practice Address - City:KIAMESHA LAKE
Practice Address - State:NY
Practice Address - Zip Code:12751-5037
Practice Address - Country:US
Practice Address - Phone:845-313-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003064103K00000X
1-23-66169103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst