Provider Demographics
NPI:1346961422
Name:ALISSE, MONICA
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:ALISSE
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 1:16210 NE 80TH ST APT 221
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-2053
Mailing Address - Country:US
Mailing Address - Phone:412-440-7003
Mailing Address - Fax:
Practice Address - Street 1:16210 NE 80TH ST APT 221
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-2053
Practice Address - Country:US
Practice Address - Phone:412-440-7003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-07
Last Update Date:2025-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program