Individual
ALYSSA CONOLLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6 N MAIN ST, FAIRPORT, NY 14450-1524
(585) 377-6590
Mailing address
21600 OXNARD ST, WOODLAND HILLS, CA 91367-4976
(818) 345-2345
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
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