Healthcare Provider Details

I. General information

NPI: 1992290803
Provider Name (Legal Business Name): ALISON MASLIJ MA, LBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2018
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 PATRIOT CIR
PLYMOUTH MTNG PA
19462-2571
US

IV. Provider business mailing address

105 PATRIOT CIR
PLYMOUTH MTNG PA
19462-2571
US

V. Phone/Fax

Practice location:
  • Phone: 610-213-7534
  • Fax:
Mailing address:
  • Phone: 610-213-7534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBH002292
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: