Provider Demographics
NPI:1811339088
Name:DARLEY, ALISSA M (SLP)
Entity type:Individual
Prefix:MRS
First Name:ALISSA
Middle Name:M
Last Name:DARLEY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:GINORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP-A
Mailing Address - Street 1:2780 SW 37TH AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:COCONUT GROVE
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2740
Mailing Address - Country:US
Mailing Address - Phone:305-622-2353
Mailing Address - Fax:
Practice Address - Street 1:2780 SW 37TH AVE STE 203
Practice Address - Street 2:
Practice Address - City:COCONUT GROVE
Practice Address - State:FL
Practice Address - Zip Code:33133
Practice Address - Country:US
Practice Address - Phone:305-622-2353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-29
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI20072355S0801X
FLSA13172235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant