Provider Demographics
NPI:1396181293
Name:CAMPBELL, ALYSSA RUTH (MS, CCC-SLP)
Entity Type:Individual
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First Name:ALYSSA
Middle Name:RUTH
Last Name:CAMPBELL
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Gender:F
Credentials:MS, CCC-SLP
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Mailing Address - Street 1:18484 PRESTON RD
Mailing Address - Street 2:SUITE 102 PMB 156
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-5400
Mailing Address - Country:US
Mailing Address - Phone:936-293-8800
Mailing Address - Fax:936-293-8841
Practice Address - Street 1:2100 SAM HOUSTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-5182
Practice Address - Country:US
Practice Address - Phone:936-293-8800
Practice Address - Fax:936-293-8841
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX106629235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist