Provider Demographics
NPI:1447709654
Name:STRUDER, ALLISON
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:STRUDER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1234 WATERFRONT DR
Mailing Address - Street 2:APT 201
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23451-6450
Mailing Address - Country:US
Mailing Address - Phone:804-514-0604
Mailing Address - Fax:
Practice Address - Street 1:1234 WATERFRONT DR
Practice Address - Street 2:APT 201
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23451-6450
Practice Address - Country:US
Practice Address - Phone:804-514-0604
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2016-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst