Provider Information for 1871093104
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ANDREA ALLI LADC LCMHC
Sex: Female
NPI: 1871093104
Last Updated: 2022-10-25
Certification Date: 2022-10-25
Certification Date: 2022-10-25
Details
| Name | Value | ||||||||||||
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| NPI | 1871093104 | ||||||||||||
| Enumeration Date | 2018-02-13 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 88 SOUTHSHIRE DR BENNINGTON, VT 05201-9139 United States Phone: 857-284-6654 | Fax: | ||||||||||||
| Primary Practice Address | 5 BANK ST NORTH BENNINGTON, VT 05257-9102 United States Phone: 802-392-9979 | Fax: | ||||||||||||
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