| Doctor Name: | ALISSA S WIBLE |
| NPI Number: | 1255612628 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LISW-S |
| License Number: | I1440201-SUPV |
| Business Practice Address: | 20525 Center Ridge Rd Suite 303 Rocky River, OH - 441163437 |
| Business Phone Number: | 4405741794 |
| Business Fax Number: | |
| Mailing Address: | 2181 Briarwood Rd, CLEVELAND HEIGHTS |
| State: | OH |
| Postal Code: | 441182833 |
| Phone Number: | 4405741794 |
| Fax Number: | |
| NPI Enumeration Date: | 08/30/2011 |
| NPI Last Update Date: | 08/21/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | I1440201-SUPV |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |