Provider Demographics
NPI:1639553340
Name:TIGHE, ALYSE LOMBARDI (AUD)
Entity Type:Individual
Prefix:
First Name:ALYSE
Middle Name:LOMBARDI
Last Name:TIGHE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ALYSE
Other - Middle Name:CATHERINE
Other - Last Name:LOMBARDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:6035 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-3256
Mailing Address - Country:US
Mailing Address - Phone:704-295-3000
Mailing Address - Fax:
Practice Address - Street 1:6035 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210-3256
Practice Address - Country:US
Practice Address - Phone:704-295-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11524231H00000X
SC4037231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSAN1617Medicaid
NC3757700OtherCIGNA
SCP01629317OtherRAILROAD MEDICARE
SCQ523475874OtherMEDICARE
NC19FX4OtherBLUE CROSS BLUE SHIELD
NCQ50740BOtherMEDICARE