Provider Demographics
NPI:1174262497
Name:TREJO, ALYSSA YVETTE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:YVETTE
Last Name:TREJO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E KELLY AVE
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4905
Mailing Address - Country:US
Mailing Address - Phone:956-784-4564
Mailing Address - Fax:
Practice Address - Street 1:601 E KELLY AVE
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4905
Practice Address - Country:US
Practice Address - Phone:956-354-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-03
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112069235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist