Provider Demographics
NPI:1760170724
Name:RICHARDS, ALLYSSA MARYA MAY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLYSSA
Middle Name:MARYA MAY
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5805 COIT RD STE 203
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6990
Mailing Address - Country:US
Mailing Address - Phone:972-964-1500
Mailing Address - Fax:
Practice Address - Street 1:5805 COIT RD STE 203
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6990
Practice Address - Country:US
Practice Address - Phone:972-964-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119206235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist