Provider Demographics
NPI:1245870310
Name:D'ARCY, ALYSSA CAMRYNE (LIC AC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CAMRYNE
Last Name:D'ARCY
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4921
Mailing Address - Country:US
Mailing Address - Phone:508-650-1921
Mailing Address - Fax:
Practice Address - Street 1:63 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4921
Practice Address - Country:US
Practice Address - Phone:508-650-1921
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist