Basic Information
| Provider Information | |||||||||
| NPI: | 1336797828 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALBRECHT | ||||||||
| FirstName: | ALYSSA | ||||||||
| MiddleName: | NICOLE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14145 SIMONE DR | ||||||||
| Address2: | |||||||||
| City: | SHELBY TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483153228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865666280 | ||||||||
| FaxNumber: | 5865661898 | ||||||||
| Practice Location | |||||||||
| Address1: | 14145 SIMONE DR | ||||||||
| Address2: | |||||||||
| City: | SHELBY TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483153228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5865666280 | ||||||||
| FaxNumber: | 5865661898 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/28/2019 | ||||||||
| LastUpdateDate: | 08/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | 7101005406 | MI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.