Provider Demographics
NPI:1134098353
Name:ROTAY, ALYSSA MARIE (MA, LBS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:ROTAY
Suffix:
Gender:F
Credentials:MA, LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 MOURNING DOVE RD
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1819
Mailing Address - Country:US
Mailing Address - Phone:610-290-3155
Mailing Address - Fax:
Practice Address - Street 1:804 MOURNING DOVE RD
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-1819
Practice Address - Country:US
Practice Address - Phone:610-290-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH008044103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst