Healthcare Provider Details
I. General information
NPI: 1396408324
Provider Name (Legal Business Name): AALIYAH NOELLE CARUSO LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/17/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
140 W SWANSON AVE
WASILLA AK
99654-6825
US
IV. Provider business mailing address
PO BOX 877816
WASILLA AK
99687-7816
US
V. Phone/Fax
- Phone: 907-414-1730
- Fax:
- Phone: 907-841-3725
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 253165 |
| License Number State | AK |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225700000X |
| Taxonomy | Massage Therapist |
| License Number | 181179 |
| License Number State | AK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: