Provider Demographics
NPI:1811768484
Name:RAVEE, ALEXANDRA M (MA, BCBA)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:M
Last Name:RAVEE
Suffix:
Gender:F
Credentials:MA, BCBA
Other - Prefix:MS
Other - First Name:ALEXANDRA
Other - Middle Name:
Other - Last Name:RYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 S ADELAIDE AVE APT 1C
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1613
Mailing Address - Country:US
Mailing Address - Phone:734-904-6979
Mailing Address - Fax:
Practice Address - Street 1:1500 AVE OF THE STATES
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4789
Practice Address - Country:US
Practice Address - Phone:844-390-3154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst