Provider Demographics
NPI:1932496288
Name:MEISELBACH, ALLISON (MSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MEISELBACH
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 MORICHES RD
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2221
Mailing Address - Country:US
Mailing Address - Phone:631-513-7628
Mailing Address - Fax:
Practice Address - Street 1:26 MORICHES RD
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2221
Practice Address - Country:US
Practice Address - Phone:631-513-7628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker