| NPI | 1245853340 |
|---|---|
| Former Name | ALYSSA COLBERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 10076) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4613-226) |
| Enumeration Date | 2020-05-22 |
| Last Update Date | 2022-10-18 |