| NPI | 1194285379 |
|---|---|
| Former Name | ALYSSA M BOSCALJON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH20181) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 17031755) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2020-11-19 |