Provider Demographics
NPI:1447585062
Name:MUHAMMAD, ALISA ROCHELLE
Entity Type:Individual
Prefix:MRS
First Name:ALISA
Middle Name:ROCHELLE
Last Name:MUHAMMAD
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 1:40 HOWLAND ST
Mailing Address - Street 2:
Mailing Address - City:DORCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:02121-1704
Mailing Address - Country:US
Mailing Address - Phone:857-492-6772
Mailing Address - Fax:
Practice Address - Street 1:40 HOWLAND ST
Practice Address - Street 2:
Practice Address - City:DORCHESTER
Practice Address - State:MA
Practice Address - Zip Code:02121-1704
Practice Address - Country:US
Practice Address - Phone:857-492-6772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-15
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor