Provider Demographics
NPI:1952772303
Name:SMEAL, ALYSSA
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:
Last Name:SMEAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:
Other - Last Name:GALIZIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:131 OLD CARRIAGE RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3331
Mailing Address - Country:US
Mailing Address - Phone:732-691-2584
Mailing Address - Fax:
Practice Address - Street 1:131 OLD CARRIAGE RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3331
Practice Address - Country:US
Practice Address - Phone:732-691-2584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-12
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL012435235Z00000X
NJ41YS00817800235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist