Healthcare Provider Details

I. General information

NPI: 1174079339
Provider Name (Legal Business Name): ALISON PALLO M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10150 HIGHLAND MANOR DR STE 200-038
TAMPA FL
33610-9713
US

IV. Provider business mailing address

9428 CERULEAN DR APT 304
RIVERVIEW FL
33578-4793
US

V. Phone/Fax

Practice location:
  • Phone: 863-602-0068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-44486
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: