Provider Demographics
NPI:1801428305
Name:TULLY, ALISON
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:TULLY
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 1:81 MORTON ST APT 3
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02720-2891
Mailing Address - Country:US
Mailing Address - Phone:978-660-3638
Mailing Address - Fax:
Practice Address - Street 1:81 MORTON ST APT 3
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2891
Practice Address - Country:US
Practice Address - Phone:978-660-3638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-12
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker