Provider Demographics
NPI:1295614295
Name:MASSEY, ALYSA
Entity type:Individual
Prefix:
First Name:ALYSA
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11017 STATE HIGHWAY U
Mailing Address - Street 2:
Mailing Address - City:MINERAL POINT
Mailing Address - State:MO
Mailing Address - Zip Code:63660-9505
Mailing Address - Country:US
Mailing Address - Phone:636-266-1200
Mailing Address - Fax:
Practice Address - Street 1:1217 W MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-1064
Practice Address - Country:US
Practice Address - Phone:636-583-2513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-02
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist