Provider Demographics
NPI:1558998237
Name:TIBERI-GALLO, ALYSSA KRISTEN (MSW, LSW)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:KRISTEN
Last Name:TIBERI-GALLO
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MORGANTOWN ST
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4871
Mailing Address - Country:US
Mailing Address - Phone:724-557-6598
Mailing Address - Fax:
Practice Address - Street 1:315 MORGANTOWN ST
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-4871
Practice Address - Country:US
Practice Address - Phone:724-557-6598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134594104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker