Individual
DR. TRACEY LEE ALYSSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2937 ROUTE 611, TANNERSVILLE, PA 18372-9990
(570) 269-5581
Mailing address
3021 VALLEY VIEW DR, BANGOR, PA 18013-6130
(603) 313-2517
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
3193
MA
103TC0700X
Clinical Psychologist
NH260
NH
103TC0700X
Clinical Psychologist
Primary
PS017890
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0602230YONHOI
ANTHEM
NH
Enumeration date
01/16/2007
Last updated
11/09/2015
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