NPI Profile for ALICIA S BALISTRERI in MOUNT PLEASANT, WI.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI # | 1528674330 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 09/17/2020 | |
| Last updated | 09/17/2020 - About 6 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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ALICIA S BALISTRERI
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