Provider Demographics
NPI:1760611347
Name:MEYERS, ALYSSA EVE (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:EVE
Last Name:MEYERS
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:MS
Other - First Name:ALYSSA
Other - Middle Name:EVE
Other - Last Name:WEINSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 CLUB DR APT 4BR
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2012
Mailing Address - Country:US
Mailing Address - Phone:516-902-7937
Mailing Address - Fax:
Practice Address - Street 1:1 CLUB DR APT 4BR
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2012
Practice Address - Country:US
Practice Address - Phone:516-902-7937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-05
Last Update Date:2009-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014224-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist