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Individual
ALLYSSA BRODY
Active
Individual
ALLYSSA BRODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
95004156
CA
390200000X
Student in an Organized Health Care Education/Training Program
22676670
NY
Other
Enumeration date
07/10/2014
Last updated
10/20/2016
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