Provider Demographics
NPI:1700906575
Name:BLOCK, ALISON P (PHD)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:P
Last Name:BLOCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MARC RD
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1113
Mailing Address - Country:US
Mailing Address - Phone:732-933-1333
Mailing Address - Fax:732-933-1139
Practice Address - Street 1:116 OCEANPORT AVE
Practice Address - Street 2:
Practice Address - City:LITTLE SILVER
Practice Address - State:NJ
Practice Address - Zip Code:07739-1207
Practice Address - Country:US
Practice Address - Phone:732-933-1333
Practice Address - Fax:732-933-1139
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00317500103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling