Provider Demographics
NPI:1902677883
Name:MAIURI-MOMBELEUR, ALYSSA ANN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:ANN
Last Name:MAIURI-MOMBELEUR
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ALYSSA
Other - Middle Name:ANN
Other - Last Name:MAIURI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:2 BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01887-2676
Mailing Address - Country:US
Mailing Address - Phone:508-527-5457
Mailing Address - Fax:
Practice Address - Street 1:2 BIRCH RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:MA
Practice Address - Zip Code:01887-2676
Practice Address - Country:US
Practice Address - Phone:508-527-5457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist