Provider Demographics
NPI:1720244692
Name:ALESSANDRELLI, LARA J (MS, CCC-A)
Entity Type:Individual
Prefix:
First Name:LARA
Middle Name:J
Last Name:ALESSANDRELLI
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:LARA
Other - Middle Name:J
Other - Last Name:CIASULLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-A
Mailing Address - Street 1:2211 LOMAS BLVD. NE 5N
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106
Mailing Address - Country:US
Mailing Address - Phone:505-272-3535
Mailing Address - Fax:505-272-0300
Practice Address - Street 1:2211 LOMAS BLVD. NE 5N
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-272-3535
Practice Address - Fax:505-272-0300
Is Sole Proprietor?:No
Enumeration Date:2008-07-31
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM5476237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter