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General NPI Number Information
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NPI Number | 1992159339
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Entity Type | Individual
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Provider Name | ALYSSA NICKERSON
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Gender | Female
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Dates
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Enumeration Date | 04/22/2016
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Last Update Date | 04/22/2016
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Provider Practice Location Address
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Address Line | 10 HOWARD ST
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City | HAVERHILL
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State | MA
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Zip | 01830-4006
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Country | US
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Telephone | 978-967-7792
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Fax |
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Provider Business Mailing Address
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Address Line | 32 ROYAL CIR
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City | SALEM
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State | NH
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Zip | 03079-2624
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Country | US
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Telephone | 603-479-2784
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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