Provider Demographics
NPI:1821569682
Name:COTTEN, ALYSSA C (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:C
Last Name:COTTEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:C
Other - Last Name:NYMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2705 N LEBANON ST STE 305
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-8622
Mailing Address - Country:US
Mailing Address - Phone:765-485-8852
Mailing Address - Fax:
Practice Address - Street 1:2485 E WABASH ST STE 100
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IN
Practice Address - Zip Code:46041-9400
Practice Address - Country:US
Practice Address - Phone:765-485-8100
Practice Address - Fax:765-485-8118
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-05
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN46003205A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist