Basic Information
| Provider Information | |||||||||
| NPI: | 1811447469 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WAYLON | ||||||||
| FirstName: | ALESSANDRA | ||||||||
| MiddleName: | ELISA | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 281 PINE RIDGE DR | ||||||||
| Address2: | |||||||||
| City: | WAPPINGERS FALLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125905920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9144504439 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1156 N BROADWAY | ||||||||
| Address2: | |||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107011108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9149653700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2016 | ||||||||
| LastUpdateDate: | 04/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 100951 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.