Provider Demographics
NPI:1750618625
Name:O'CONNOR, ALYSON H (BCBA)
Entity type:Individual
Prefix:
First Name:ALYSON
Middle Name:H
Last Name:O'CONNOR
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 1:862 LIVE OAK LN
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-9533
Mailing Address - Country:US
Mailing Address - Phone:832-865-4577
Mailing Address - Fax:
Practice Address - Street 1:862 LIVE OAK LN
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-9533
Practice Address - Country:US
Practice Address - Phone:832-865-4577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-12
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-08-4209103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst