Individual
ALISA MO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
700 CHILDRENS DR, COLUMBUS, OH 43205-2664
(614) 722-2000
Mailing address
300 LONGWOOD AVE, BOSTON CHILDREN'S HOSPITAL, BOSTON, MA 02115-5724
(617) 355-6000
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
291618
MA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
35.154221
OH
Other
Enumeration date
04/21/2016
Last updated
05/14/2026
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