Provider Demographics
NPI:1982296497
Name:TAMBURO, ALYSSA (MA)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:TAMBURO
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 ORLEANS PLACE
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-7514
Mailing Address - Country:US
Mailing Address - Phone:318-914-2928
Mailing Address - Fax:
Practice Address - Street 1:303 MCMILLAN RD
Practice Address - Street 2:SUITE C
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291-8302
Practice Address - Country:US
Practice Address - Phone:318-202-9293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-05
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional