Provider Demographics
NPI:1851109532
Name:PACKER, ALYSSA BELLE (MT-BC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:BELLE
Last Name:PACKER
Suffix:
Gender:
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:274 SUTTON RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-3521
Mailing Address - Country:US
Mailing Address - Phone:513-653-0839
Mailing Address - Fax:
Practice Address - Street 1:274 SUTTON RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-3521
Practice Address - Country:US
Practice Address - Phone:513-653-0839
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-26
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator