Provider Demographics
NPI:1033607593
Name:JAGERMAN, ALYSSA BROOKE
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:BROOKE
Last Name:JAGERMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 JOHN ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-2930
Mailing Address - Country:US
Mailing Address - Phone:631-424-2900
Mailing Address - Fax:
Practice Address - Street 1:3215 USHANT CT
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414-7437
Practice Address - Country:US
Practice Address - Phone:631-213-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-30
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical