Provider Demographics
NPI:1881362606
Name:MOLINA, ALYSSA (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MOLINA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 LARCHMONT CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60565-2256
Mailing Address - Country:US
Mailing Address - Phone:630-453-7877
Mailing Address - Fax:
Practice Address - Street 1:960 E CHICAGO AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-5510
Practice Address - Country:US
Practice Address - Phone:630-453-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-06
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist