Provider Demographics
NPI:1366270423
Name:ISMAIL, ALNISA (BCBA)
Entity type:Individual
Prefix:
First Name:ALNISA
Middle Name:
Last Name:ISMAIL
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 1:1256 MARLKRESS RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-2626
Mailing Address - Country:US
Mailing Address - Phone:856-888-1097
Mailing Address - Fax:
Practice Address - Street 1:316 W WESTFIELD AVE
Practice Address - Street 2:
Practice Address - City:ROSELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07204-1841
Practice Address - Country:US
Practice Address - Phone:888-966-0746
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-22
Last Update Date:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst