Individual
JENNIFER ALFONSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103TC1900X
Counseling Psychologist
Primary
006316
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303295
—
MA
05
—
1307576
—
MA
01
—
M18463
BLUE CROSS BLUE SHIELD
MA
Enumeration date
07/29/2014
Last updated
08/26/2019
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