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General NPI Number Information
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NPI Number | 1073420212
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Entity Type | Individual
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Provider Name | ALYSSA LEONG MA
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Gender | Female
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Dates
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Enumeration Date | 08/25/2026
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Last Update Date | 08/25/2026
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Provider Practice Location Address
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Address Line | 100 E SYBELIA AVE STE 260
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City | MAITLAND
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State | FL
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Zip | 32751-4709
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Country | US
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Telephone | 321-209-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 4455 WILLA CREEK DR APT 213
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City | WINTER SPRINGS
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State | FL
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Zip | 32708-5207
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Country | US
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Telephone | 561-676-0518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | IMH29715
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License Number State | FL
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