Individual
ALYSSA REVUELTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10 RESOLUTE LN, SUITE 207, MT PLEASANT, SC 29464-6608
(843) 810-9682
(843) 408-4478
Mailing address
10 RESOLUTE LN, SUITE 207, MT PLEASANT, SC 29464-6608
(843) 810-9682
(843) 408-4478
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
1184
SC
Other
Enumeration date
10/01/2007
Last updated
11/13/2012
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