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General NPI Number Information
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NPI Number | 1528442928
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Entity Type | Individual
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Provider Name | ALLYSE GASTEL SLP-CCC
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Gender | Female
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Dates
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Enumeration Date | 07/15/2015
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Last Update Date | 10/07/2021
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Provider Practice Location Address
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Address Line | 1750 E 234TH ST
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City | EUCLID
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State | OH
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Zip | 44117-1913
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Country | US
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Telephone | 216-797-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 1750 E 234TH ST
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City | EUCLID
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State | OH
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Zip | 44117-1913
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Country | US
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Telephone | 216-797-6400
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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 | 5343
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SP.14365
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License Number State | OH
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