Provider Demographics
NPI:1902938590
Name:GREER, ALYSSA (PHD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:GREER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6944 W FOREST HOME AVE
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53220-2917
Mailing Address - Country:US
Mailing Address - Phone:262-719-3824
Mailing Address - Fax:414-321-8588
Practice Address - Street 1:6944 W FOREST HOME AVE
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-2917
Practice Address - Country:US
Practice Address - Phone:262-719-3824
Practice Address - Fax:414-321-8588
Is Sole Proprietor?:No
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2637-057103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical