Provider Demographics
NPI:1568024412
Name:ROBERTS, ALLISON EVE HOPE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:EVE HOPE
Last Name:ROBERTS
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:PO BOX 907
Mailing Address - Street 2:
Mailing Address - City:VINEYARD HAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02568-0900
Mailing Address - Country:US
Mailing Address - Phone:774-353-6415
Mailing Address - Fax:
Practice Address - Street 1:66 TROY ST STE 4&5
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-3023
Practice Address - Country:US
Practice Address - Phone:508-676-5708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health