Provider Demographics
NPI:1699175919
Name:WOJTYNA, ALYSSA
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:
Last Name:WOJTYNA
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 1:4515 RUDOLPH RD
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-7919
Mailing Address - Country:US
Mailing Address - Phone:920-619-0311
Mailing Address - Fax:
Practice Address - Street 1:4515 RUDOLPH RD
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-7919
Practice Address - Country:US
Practice Address - Phone:920-619-0311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-25
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4222235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist