Healthcare Provider Details

I. General information

NPI: 1972276178
Provider Name (Legal Business Name): ALYSSA POND LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2021
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7322 W RAWSON AVE
FRANKLIN WI
53132-8117
US

IV. Provider business mailing address

7322 W RAWSON AVE
FRANKLIN WI
53132-8117
US

V. Phone/Fax

Practice location:
  • Phone: 414-228-4800
  • Fax: 414-433-9007
Mailing address:
  • Phone: 414-228-4800
  • Fax: 414-433-9007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: