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General NPI Number Information
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NPI Number | 1194347955
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Entity Type | Organization
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Legal Business Name | ALYSSA CASCIOTTA PSYD LLC
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Dates
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Enumeration Date | 05/14/2020
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Last Update Date | 05/14/2020
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Provider Practice Location Address
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Address Line | 4929 RIVER WIND POINTE DRIVE SUITE 102
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City | EVANSVILLE
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State | IN
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Zip | 47715-6753
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Country | US
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Telephone | 812-437-0095
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Fax | 812-437-0096
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Provider Business Mailing Address
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Address Line | 4929 RIVERWIND POINTE DR STE 102
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City | EVANSVILLE
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State | IN
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Zip | 47715-6753
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Country | US
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Telephone | 812-437-0095
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Fax | 812-437-0096
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | DR. ALYSSA M CASCIOTTA
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Credential | PSYD, HSPP
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Telephone | 812-437-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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