National Provider Identifier

Alisa O'Riley Hannum, PH.D.

Alisa O'Riley Hannum, PH.D. is listed in the NPPES registry with a primary specialty of Clinical Psychologist in Farmington, NY and a listed phone number of (650) 833-8357.

NPI 1447506621Farmington, NYClinical Psychologist

Profile Overview

NPI
1447506621
Provider Type
Individual
Primary Specialty
Clinical Psychologist
Enumeration Date
July 25, 2012
Last Updated
May 01, 2024

Practice Location

  • 1130 Willow Brook Bnd
  • Farmington, NY 14425-9064

Phone: (650) 833-8357

Mailing Address

  • 5585 Erindale Dr Ste 203
  • Colorado Springs, CO 80918-6969

Specialties

  • Clinical Psychologist (103TC0700X)
Full Record
NPI
1447506621
Entity Type
Individual
Last Name
Hannum
First Name
Alisa
Middle Name
O'Riley
Credential
PH.D.
Provider Other Last Name
O'Riley
Provider Other First Name
Alisa
Provider Other Middle Name
Anne
Provider Other Credential Text
PHD
Provider Other Last Name Type Code
1
Mailing Street Address
5585 Erindale Dr Ste 203
Mailing City
Colorado Springs
Mailing State
CO
Mailing ZIP Code
80918-6969
Mailing Country
US
Practice Street Address
1130 Willow Brook Bnd
Practice City
Farmington
Practice State
NY
Practice ZIP Code
14425-9064
Practice Country
US
Practice Phone
(650) 833-8357
Enumeration Date
July 25, 2012
Last Updated
May 01, 2024
Sex
Female
Sole Proprietor
Yes
Certification Date
May 01, 2024
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Clinical Psychologist (103TC0700X)