Provider Demographics
NPI:1669127502
Name:MCALISTER, AMY MARIE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:MARIE
Last Name:MCALISTER
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 1:375 980 RD
Mailing Address - Street 2:
Mailing Address - City:MC DONALD
Mailing Address - State:PA
Mailing Address - Zip Code:15057-2842
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:375 980 RD
Practice Address - Street 2:
Practice Address - City:MC DONALD
Practice Address - State:PA
Practice Address - Zip Code:15057-2842
Practice Address - Country:US
Practice Address - Phone:724-970-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-18
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000682103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst