Provider Demographics
NPI:1831614957
Name:MOLFESE, ALYSSA MARIE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:MARIE
Last Name:MOLFESE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 UNION ST STE 203
Mailing Address - Street 2:
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-4219
Mailing Address - Country:US
Mailing Address - Phone:609-436-5740
Mailing Address - Fax:609-436-5741
Practice Address - Street 1:1 UNION ST STE 203
Practice Address - Street 2:
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-4219
Practice Address - Country:US
Practice Address - Phone:609-436-5740
Practice Address - Fax:609-436-5741
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2019-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00742800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist