Provider Demographics
NPI:1578720256
Name:DENTLER, ALYSHA LYNN
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:LYNN
Last Name:DENTLER
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 1:109 FALLS COURT STE 600
Mailing Address - Street 2:BOERNE JUST-4-KIDS THERAPY SERVICES
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006
Mailing Address - Country:US
Mailing Address - Phone:830-249-9493
Mailing Address - Fax:
Practice Address - Street 1:109 FALLS COURT STE 600
Practice Address - Street 2:BOERNE JUST-4-KIDS THERAPY SERVICES
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-2983
Practice Address - Country:US
Practice Address - Phone:830-249-9493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103374235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist