Provider Demographics
NPI:1336741602
Name:ALBRIGHT, AMY (BCBA, LBA)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ALBRIGHT
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 1:119 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05464-8700
Mailing Address - Country:US
Mailing Address - Phone:860-215-5156
Mailing Address - Fax:
Practice Address - Street 1:72 HARREL ST
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:VT
Practice Address - Zip Code:05661-8526
Practice Address - Country:US
Practice Address - Phone:802-888-5026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT146.0134186103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst