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NPI 1346920147

NPI 1346920147 : ALLISON BAILEY BUSSERT ED.M : QUINCY, MA

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General NPI Number Information
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    NPI Number           |    1346920147
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    Entity Type          |    Individual 
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    Provider Name        |    ALLISON BAILEY BUSSERT ED.M
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/18/2023
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    Last Update Date     |    07/18/2023
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Provider Practice Location Address
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    Address Line         |    100 HANCOCK ST FL 9 
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    City                 |    QUINCY
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    State                |    MA
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    Zip                  |    02171-1745
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    Country              |    US
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    Telephone            |    617-410-9328
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    PO BOX 122 
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    City                 |    WARRENTON
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    State                |    OR
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    Zip                  |    97146-0122
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    Country              |    US
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    Telephone            |    503-468-8435
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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       |    
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    License Number State |    MA
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