| Doctor Name: | DR. TRACEY LEE ALYSSON |
| NPI Number: | 1427109289 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 3193 |
| Business Practice Address: | 2937 Route 611 Tannersville, PA - 183729990 |
| Business Phone Number: | 5702695581 |
| Business Fax Number: | |
| Mailing Address: | 3021 Valley View Dr, BANGOR |
| State: | PA |
| Postal Code: | 180136130 |
| Phone Number: | 6033132517 |
| Fax Number: | |
| NPI Enumeration Date: | 01/16/2007 |
| NPI Last Update Date: | 11/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 3193 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |