Individual provider · NPI-1
Alyssa Bohonan
Counselor, Mental Health · Islandia, NY
NPI number1023699006
StatusActive
Last updated in NPPESApr 20, 2021
Details
- NPI
- 1023699006
- Entity type
- Individual (NPI-1)
- Name
- Alyssa Bohonan
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 20, 2021
- Certification date
- Nov 13, 2020
- Last updated
- Apr 20, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | 009109 | NY | Yes |
Practice location
1777 Veterans Memorial Hwy Ste 14Islandia, NY 11749-1555
Phone 631-630-6439
Mailing address
58 Pitchpine PlMedford, NY 11763-4226
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