Individual
ALLYSSA MITRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 MAIN ST STE 30, TEWKSBURY, MA 01876-4700
(508) 363-0200
Mailing address
1501 MAIN ST STE 30, TEWKSBURY, MA 01876-4700
(508) 363-0200
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110026265E
—
MA
Enumeration date
05/14/2014
Last updated
07/27/2021
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