Provider Demographics
NPI:1710478797
Name:PRESTIA, ALAYSHA
Entity Type:Individual
Prefix:
First Name:ALAYSHA
Middle Name:
Last Name:PRESTIA
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 1:1112 SILVERTON RD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-2157
Mailing Address - Country:US
Mailing Address - Phone:848-459-2916
Mailing Address - Fax:
Practice Address - Street 1:1112 SILVERTON RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-2157
Practice Address - Country:US
Practice Address - Phone:848-459-2916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06355900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker