Provider Demographics
NPI:1235474586
Name:KLEIN, ALYSON R (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALYSON
Middle Name:R
Last Name:KLEIN
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 1:5170 CENTRAL SARASOTA PKWY
Mailing Address - Street 2:APT. 302
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-7611
Mailing Address - Country:US
Mailing Address - Phone:516-729-1389
Mailing Address - Fax:
Practice Address - Street 1:4602 NORTHGATE CT
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34234-2125
Practice Address - Country:US
Practice Address - Phone:941-355-2913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA10510235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist