Provider Demographics
NPI:1184138729
Name:SPEARS, ALISSA ROSE (MS, MBA)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:ROSE
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MS, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3531 FOX CHASE DR
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:PA
Mailing Address - Zip Code:15126-9604
Mailing Address - Country:US
Mailing Address - Phone:724-971-9679
Mailing Address - Fax:
Practice Address - Street 1:3531 FOX CHASE DR
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:PA
Practice Address - Zip Code:15126-9604
Practice Address - Country:US
Practice Address - Phone:724-971-9679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator