Provider Demographics
NPI:1013543883
Name:FISHER, ALYSIA ELIZABETH (MHS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSIA
Middle Name:ELIZABETH
Last Name:FISHER
Suffix:
Gender:F
Credentials:MHS, CCC-SLP
Other - Prefix:MISS
Other - First Name:ALYSIA
Other - Middle Name:ELIZABETH
Other - Last Name:CAREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MHS, CCC-SLP
Mailing Address - Street 1:112 S PINE ST
Mailing Address - Street 2:
Mailing Address - City:ELDON
Mailing Address - State:MO
Mailing Address - Zip Code:65026-1581
Mailing Address - Country:US
Mailing Address - Phone:573-392-8000
Mailing Address - Fax:
Practice Address - Street 1:112 S PINE ST
Practice Address - Street 2:
Practice Address - City:ELDON
Practice Address - State:MO
Practice Address - Zip Code:65026-1581
Practice Address - Country:US
Practice Address - Phone:573-392-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016020627235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist