Basic Information
| Provider Information | |||||||||
| NPI: | 1972030609 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NESLER | ||||||||
| FirstName: | ALYSSA | ||||||||
| MiddleName: | |||||||||
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| Credential: | CCC-SLP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SPIELMAN | ||||||||
| OtherFirstName: | ALYSSA | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | CCC-SLP | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6000 HAMPTON CTR | ||||||||
| Address2: | STE B | ||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265050651 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045991500 | ||||||||
| FaxNumber: | 3045997800 | ||||||||
| Practice Location | |||||||||
| Address1: | 37 GRANDE MEADOWS DR | ||||||||
| Address2: | STE102 | ||||||||
| City: | BRIDGEPORT | ||||||||
| State: | WV | ||||||||
| PostalCode: | 263309035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3045922009 | ||||||||
| FaxNumber: | 3045922004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2017 | ||||||||
| LastUpdateDate: | 07/12/2022 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 07/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SLP-1776 | WV | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.