Provider Demographics
NPI:1255618138
Name:ALBRECHT, ALYSSA (ATC)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:SORENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10220 13TH ST SE
Mailing Address - Street 2:
Mailing Address - City:WIMBLEDON
Mailing Address - State:ND
Mailing Address - Zip Code:58492-9514
Mailing Address - Country:US
Mailing Address - Phone:701-840-2751
Mailing Address - Fax:
Practice Address - Street 1:2192 101ST AVE SE
Practice Address - Street 2:
Practice Address - City:WIMBLEDON
Practice Address - State:ND
Practice Address - Zip Code:58492-9353
Practice Address - Country:US
Practice Address - Phone:701-840-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-07
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND363-092255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer