Provider Demographics
NPI:1063688364
Name:JEBITSCH, ALISSA MARIE (MS)
Entity Type:Individual
Prefix:MS
First Name:ALISSA
Middle Name:MARIE
Last Name:JEBITSCH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 HARRISON ST APT 225
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3170
Mailing Address - Country:US
Mailing Address - Phone:610-462-3888
Mailing Address - Fax:
Practice Address - Street 1:701 HARRISON ST APT 225
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3170
Practice Address - Country:US
Practice Address - Phone:610-462-3888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator