Provider Demographics
NPI:1962730424
Name:MESTROVICH SEAY, ALIAH KRISTIN (BS)
Entity type:Individual
Prefix:
First Name:ALIAH
Middle Name:KRISTIN
Last Name:MESTROVICH SEAY
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4606 SUNFLOWER SLOPE DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-1811
Mailing Address - Country:US
Mailing Address - Phone:949-315-6116
Mailing Address - Fax:
Practice Address - Street 1:4606 SUNFLOWER SLOPE DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-1811
Practice Address - Country:US
Practice Address - Phone:949-315-6116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-20
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KS855106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health