Provider Demographics
NPI:1083250104
Name:BAUMAN, ALYSSA LAUREL
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LAUREL
Last Name:BAUMAN
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 1:333 N BRADDOCK AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2512
Mailing Address - Country:US
Mailing Address - Phone:412-864-5004
Mailing Address - Fax:
Practice Address - Street 1:513 JEANETTE ST APT 1
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-3509
Practice Address - Country:US
Practice Address - Phone:412-400-4044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health