Individual
ALYSSA HOPE DIGIACOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10272 S US HIGHWAY 1, PORT ST LUCIE, FL 34952-5615
(772) 872-6940
Mailing address
9773 SW SANTA MONICA DR, PALM CITY, FL 34990-5910
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
22-224087
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114905600
—
FL
Enumeration date
10/13/2022
Last updated
01/18/2024
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