Provider Demographics
NPI:1194688614
Name:MYSLIWIEC, ALLISON R (CT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:R
Last Name:MYSLIWIEC
Suffix:
Gender:F
Credentials:CT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12677 TALL TIMBER CIR
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-3711
Mailing Address - Country:US
Mailing Address - Phone:216-562-7214
Mailing Address - Fax:
Practice Address - Street 1:12677 TALL TIMBER CIR
Practice Address - Street 2:
Practice Address - City:NORTH ROYALTON
Practice Address - State:OH
Practice Address - Zip Code:44133-3711
Practice Address - Country:US
Practice Address - Phone:216-562-7214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2507238-TRNE101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health