Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | 44SL06084600 | NJ |
NPI | 1003354200 |
---|---|
Provider Name | Alyssa Allotta |
First Address | Manahawkin, NJ 08050-5006 |
Second Address | Manahawkin, NJ 08050-5006 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2017 |
Last Update Date | 08/02/2017 |