Provider Demographics
NPI:1386342418
Name:NELSON, ALLYSON HAHL (MA, EDS)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:HAHL
Last Name:NELSON
Suffix:
Gender:F
Credentials:MA, EDS
Other - Prefix:
Other - First Name:ALLYSON
Other - Middle Name:
Other - Last Name:PRICE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, EDS
Mailing Address - Street 1:405 PARK DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIXVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19460-3623
Mailing Address - Country:US
Mailing Address - Phone:484-942-0629
Mailing Address - Fax:
Practice Address - Street 1:1200 ATWATER DR
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-8782
Practice Address - Country:US
Practice Address - Phone:484-942-0629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA4651748103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA4651748OtherSCHOOL PSYCHOLOGIST