Healthcare Provider Details
I. General information
NPI: 1699930909
Provider Name (Legal Business Name): LORI ALESSI M.S., CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/25/2008
Last Update Date: 07/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
82 THOMAS JOHNSON CT
FREDERICK MD
21702-4348
US
IV. Provider business mailing address
82 THOMAS JOHNSON CT
FREDERICK MD
21702-4348
US
V. Phone/Fax
- Phone: 301-698-2440
- Fax: 301-846-0892
- Phone: 301-698-2440
- Fax: 301-846-0892
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | 01057 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: