Provider Demographics
NPI:1609360932
Name:PORRATA-DORIA, ALYZZA LESLIE (SLPA)
Entity Type:Individual
Prefix:
First Name:ALYZZA
Middle Name:LESLIE
Last Name:PORRATA-DORIA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7312 GOLDENPOINTE BLVD APT 106
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807-6146
Mailing Address - Country:US
Mailing Address - Phone:407-923-6025
Mailing Address - Fax:
Practice Address - Street 1:7312 GOLDENPOINTE BLVD APT 106
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807-6146
Practice Address - Country:US
Practice Address - Phone:407-923-6025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSL35942355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant