Provider Demographics
NPI:1528557170
Name:SCOLARI, ALYSSA NICOLE (MA, LA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:NICOLE
Last Name:SCOLARI
Suffix:
Gender:F
Credentials:MA, LA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 YORKTOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMMONTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08037-2101
Mailing Address - Country:US
Mailing Address - Phone:609-519-6913
Mailing Address - Fax:
Practice Address - Street 1:342 EGG HARBOR RD STE B
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-1856
Practice Address - Country:US
Practice Address - Phone:856-589-3420
Practice Address - Fax:856-345-2820
Is Sole Proprietor?:No
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00357506101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor