Provider Demographics
NPI:1720711120
Name:GEHRMAN, ALISON NICOLE (MED, BCBA, LBA, LABA)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:NICOLE
Last Name:GEHRMAN
Suffix:
Gender:F
Credentials:MED, BCBA, LBA, LABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 MAIN DUNSTABLE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3640
Mailing Address - Country:US
Mailing Address - Phone:844-902-4222
Mailing Address - Fax:561-210-5502
Practice Address - Street 1:155 MAIN DUNSTABLE RD STE 150
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3640
Practice Address - Country:US
Practice Address - Phone:561-335-5681
Practice Address - Fax:561-210-5502
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2023-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALABA10000187103K00000X
AZBEH-000988103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
1-22-59913OtherBCBA CERTIFICATE