Provider Demographics
NPI:1487469599
Name:ROMER, ALYSSA MICHELLE
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:MICHELLE
Last Name:ROMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 N WOODS RD
Mailing Address - Street 2:
Mailing Address - City:BAITING HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:11933-2308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:80 FRONT STREET
Practice Address - Street 2:
Practice Address - City:WADING RIVER
Practice Address - State:NY
Practice Address - Zip Code:11792
Practice Address - Country:US
Practice Address - Phone:631-576-7930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist