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General NPI Number Information
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NPI Number | 1932794286
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Entity Type | Individual
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Provider Name | ALIYATTA PAULLONE WESTON MS IN PSYCHOLOGY
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Gender | Female
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Dates
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Enumeration Date | 03/08/2021
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 540 SW FEDORA WAY
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City | LAKE CITY
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State | FL
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Zip | 32025
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Country | US
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Telephone | 386-361-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 129 SE LEMON WAY
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City | LAKE CITY
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State | FL
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Zip | 32025-2273
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Country | US
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Telephone | 386-361-1455
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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 | MH19017
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License Number State | FL
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Taxonomy #2
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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 | FL
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