Provider Demographics
NPI:1134879059
Name:ALISON NIBLICK
Entity type:Organization
Organization Name:ALISON NIBLICK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST, BUSINESS OWN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:NIBLICK
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:484-714-0376
Mailing Address - Street 1:4011 SCHAEFFER DR
Mailing Address - Street 2:
Mailing Address - City:WALNUTPORT
Mailing Address - State:PA
Mailing Address - Zip Code:18088-9593
Mailing Address - Country:US
Mailing Address - Phone:484-714-0376
Mailing Address - Fax:
Practice Address - Street 1:4011 SCHAEFFER DR
Practice Address - Street 2:
Practice Address - City:WALNUTPORT
Practice Address - State:PA
Practice Address - Zip Code:18088-9593
Practice Address - Country:US
Practice Address - Phone:484-714-0376
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-24
Last Update Date:2022-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)