Provider Demographics
NPI:1528624426
Name:DALLERA, ALESSANDRA DESIREE (NAPRAPATHIC DOCTOR)
Entity type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:DESIREE
Last Name:DALLERA
Suffix:
Gender:F
Credentials:NAPRAPATHIC DOCTOR
Other - Prefix:
Other - First Name:ALESSANDRA
Other - Middle Name:DESIREE
Other - Last Name:DALLERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1640 JAY ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-3893
Mailing Address - Country:US
Mailing Address - Phone:505-913-9323
Mailing Address - Fax:505-992-0077
Practice Address - Street 1:1640 JAY ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-3893
Practice Address - Country:US
Practice Address - Phone:505-913-9323
Practice Address - Fax:505-992-0077
Is Sole Proprietor?:No
Enumeration Date:2019-05-15
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM01025172P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172P00000XOther Service ProvidersNaprapath