Provider Demographics
NPI:1972860179
Name:POPE, ALYSSA LEE (SLPA)
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:LEE
Last Name:POPE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W 26TH ST RM 522
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1137
Mailing Address - Country:US
Mailing Address - Phone:212-268-5999
Mailing Address - Fax:
Practice Address - Street 1:601 W 26TH ST RM 522
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1137
Practice Address - Country:US
Practice Address - Phone:212-268-5999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MASP-839-SA2355S0801X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant