Provider Demographics
NPI:1508452848
Name:SAMPERI, ALYSSA M (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:M
Last Name:SAMPERI
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 1:12 GLENAIR AVE
Mailing Address - Street 2:
Mailing Address - City:WALDWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:07463-1215
Mailing Address - Country:US
Mailing Address - Phone:201-566-5156
Mailing Address - Fax:
Practice Address - Street 1:12 GLENAIR AVE
Practice Address - Street 2:
Practice Address - City:WALDWICK
Practice Address - State:NJ
Practice Address - Zip Code:07463-1215
Practice Address - Country:US
Practice Address - Phone:201-566-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-20
Last Update Date:2020-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01024500235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty