Provider Demographics
NPI:1770738064
Name:HEIGL JONES, ALISA LS (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALISA
Middle Name:LS
Last Name:HEIGL JONES
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:ALISA
Other - Middle Name:L
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:9 BIRCHWOOD DR W
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-2103
Mailing Address - Country:US
Mailing Address - Phone:845-247-0958
Mailing Address - Fax:
Practice Address - Street 1:9 BIRCHWOOD DR W
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-2103
Practice Address - Country:US
Practice Address - Phone:845-247-0958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007569-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist