Doctor Name: | MS. ALYSSE DAANSEN FOSTER |
NPI Number: | 1053746206 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 752359131 |
Business Practice Address: | 5415 County Road 30 Canandaigua, NY - 144247964 |
Business Phone Number: | 5853941190 |
Business Fax Number: | |
Mailing Address: | 5415 County Road 30, CANANDAIGUA |
State: | NY |
Postal Code: | 144247964 |
Phone Number: | 5853941190 |
Fax Number: | |
NPI Enumeration Date: | 09/06/2013 |
NPI Last Update Date: | 09/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 752359131 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |