| NPI | 1699517920 |
|---|---|
| Former Name | ALYSSA BOLTSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist, School (Licence: FL 12274) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: FL 12274) |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-07 |