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General NPI Number Information
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NPI Number | 1023828365
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Entity Type | Individual
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Provider Name | ALYSSA DAWN COZZENS MILNE
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Gender | Female
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Dates
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Enumeration Date | 01/09/2025
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 4670 11TH ST
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City | EAST MOLINE
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State | IL
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Zip | 61244-4428
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Country | US
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Telephone | 309-796-2500
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Fax |
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Provider Business Mailing Address
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Address Line | 3818 PRAIRIE LN
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City | BETTENDORF
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State | IA
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Zip | 52722-2249
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Country | US
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Telephone | 915-204-0655
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 146018130
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License Number State | IL
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