| NPI | 1073981213 |
|---|---|
| Former Name | ALYSSA DALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701006312) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701006312) |
| Enumeration Date | 2015-09-04 |
| Last Update Date | 2020-03-23 |