Basic Information
| Provider Information | |||||||||
| NPI: | 1043651391 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BERNAT | ||||||||
| FirstName: | ALESA | ||||||||
| MiddleName: | NICHOLE | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A., CCC-SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | LEHNHARDT | ||||||||
| OtherFirstName: | ALESA | ||||||||
| OtherMiddleName: | NICHOLE | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 25059 WOOLWORTH ST | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 136199597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154935000 | ||||||||
| FaxNumber: | 3154935091 | ||||||||
| Practice Location | |||||||||
| Address1: | 25059 WOOLWORTH ST | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 136199597 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154935000 | ||||||||
| FaxNumber: | 3154935091 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2013 | ||||||||
| LastUpdateDate: | 08/11/2015 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235500000X | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist |
No ID Information.