Provider Demographics
NPI:1912329293
Name:PALTY, ALYSSA (MC)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:PALTY
Suffix:
Gender:F
Credentials:MC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5353 S COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-1852
Mailing Address - Country:US
Mailing Address - Phone:303-594-1599
Mailing Address - Fax:
Practice Address - Street 1:1255 W BASELINE RD
Practice Address - Street 2:SUITE B258
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85202-5820
Practice Address - Country:US
Practice Address - Phone:480-296-2078
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-06
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health