Provider Demographics
NPI:1164904058
Name:DOOLITTLE, ALYSSA M (MS,)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:DOOLITTLE
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:PO BOX 1122
Mailing Address - Street 2:
Mailing Address - City:E SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-2122
Mailing Address - Country:US
Mailing Address - Phone:508-566-0824
Mailing Address - Fax:
Practice Address - Street 1:1185 FALMOUTH RD
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02632-3066
Practice Address - Country:US
Practice Address - Phone:508-540-6550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-06
Last Update Date:2018-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT068.0116050101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health