Provider Demographics
NPI:1720565955
Name:FICHTELBERG, ALANA KAYE (MA , CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:KAYE
Last Name:FICHTELBERG
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 1:5100 NORTH NOB HILL ROAD
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351
Mailing Address - Country:US
Mailing Address - Phone:954-315-8687
Mailing Address - Fax:954-449-1242
Practice Address - Street 1:5100 NORTH NOB HILL ROAD
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-315-8687
Practice Address - Fax:954-449-2422
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA13888235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist