Healthcare Provider Details

I. General information

NPI: 1912259714
Provider Name (Legal Business Name): ALYSSA B LAMBERT M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2012
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

119 ORCHARD WOODS DR
SAUNDERSTOWN RI
02874-2143
US

IV. Provider business mailing address

119 ORCHARD WOODS DR
SAUNDERSTOWN RI
02874-2143
US

V. Phone/Fax

Practice location:
  • Phone: 401-287-2102
  • Fax:
Mailing address:
  • Phone: 401-287-2102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP00527
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: