Provider Demographics
NPI:1073192845
Name:QUENZEL, ALYSSA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:QUENZEL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:ELMER
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-2217
Mailing Address - Country:US
Mailing Address - Phone:856-275-1401
Mailing Address - Fax:
Practice Address - Street 1:300 CREEK VIEW RD STE 100
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-8546
Practice Address - Country:US
Practice Address - Phone:302-307-3702
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-07
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB1-0011264103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical