Provider Demographics
NPI:1649628835
Name:WILKINSON, ALYSSA MARIE (SLP)
Entity type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:MARIE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:FRANCESCHELLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:1932 NILES CORTLAND RD NE STE S
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44484-1055
Mailing Address - Country:US
Mailing Address - Phone:330-856-1520
Mailing Address - Fax:330-856-7342
Practice Address - Street 1:1932 NILES CORTLAND RD NE STE S
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44484-1055
Practice Address - Country:US
Practice Address - Phone:330-856-1520
Practice Address - Fax:330-856-7342
Is Sole Proprietor?:No
Enumeration Date:2016-05-27
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.12557235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0332062Medicaid