Provider Demographics
NPI:1336521384
Name:CETTA, ALYSSA (MS CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:
Last Name:CETTA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 ZALESKI DR
Mailing Address - Street 2:
Mailing Address - City:SAYREVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08872-1920
Mailing Address - Country:US
Mailing Address - Phone:646-369-4147
Mailing Address - Fax:
Practice Address - Street 1:38 ZALESKI DR
Practice Address - Street 2:
Practice Address - City:SAYREVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08872-1920
Practice Address - Country:US
Practice Address - Phone:646-369-4147
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025622235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist