Provider Demographics
NPI:1225513724
Name:HALL, ALYSSA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 CAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-6175
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-6175
Practice Address - Country:US
Practice Address - Phone:607-286-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2022-01-26
Deactivation Date:2019-01-25
Deactivation Code:
Reactivation Date:2022-01-26
Provider Licenses
StateLicense IDTaxonomies
NY028205235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY025205OtherNYS LICENSE