Provider Demographics
NPI:1275043515
Name:PENNACCHIO, ALLISON FRANCES
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:FRANCES
Last Name:PENNACCHIO
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:F
Other - Last Name:PENNACCHIO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:17 COOLIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MELROSE
Mailing Address - State:MA
Mailing Address - Zip Code:02176-1409
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:110 BOSTON ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-1402
Practice Address - Country:US
Practice Address - Phone:781-254-1290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-30
Last Update Date:2017-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health