Provider Demographics
NPI:1730653106
Name:DALESSANDRO, SUSAN E (MT-BC)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:E
Last Name:DALESSANDRO
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:737 SPENCER AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3157
Mailing Address - Country:US
Mailing Address - Phone:252-333-4535
Mailing Address - Fax:
Practice Address - Street 1:737 SPENCER AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3157
Practice Address - Country:US
Practice Address - Phone:252-333-4535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA13064225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist