Provider Demographics
NPI:1952919805
Name:OTTMAR, ALYSSA ANNE (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:ANNE
Last Name:OTTMAR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:ALYSSA
Other - Middle Name:ANNE
Other - Last Name:ADAMEC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:532 EASTBURY DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245-7612
Mailing Address - Country:US
Mailing Address - Phone:319-530-1275
Mailing Address - Fax:
Practice Address - Street 1:2615 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-9565
Practice Address - Country:US
Practice Address - Phone:319-351-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-16
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA096639231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist