Provider Demographics
NPI:1306550728
Name:MEZEN, ALISON LAUREN
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:LAUREN
Last Name:MEZEN
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 1:1271 8TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:METLAKATLA
Mailing Address - State:CA
Mailing Address - Zip Code:99926
Mailing Address - Country:US
Mailing Address - Phone:907-886-6911
Mailing Address - Fax:
Practice Address - Street 1:1271 8TH AVENUE
Practice Address - Street 2:1271 8TH AVENUE
Practice Address - City:METLAKATLA
Practice Address - State:AK
Practice Address - Zip Code:99926-9992
Practice Address - Country:US
Practice Address - Phone:907-886-6911
Practice Address - Fax:907-886-6917
Is Sole Proprietor?:No
Enumeration Date:2023-01-10
Last Update Date:2023-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health