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NPI Code Detail

MEDICARE: ALYSSA ESPINALES M.S. CCC SLP

MEDICARE: ALYSSA ESPINALES M.S. CCC SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist14066953OK

General Provider Information

NPI Number : 1093172041
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALYSSA ESPINALES M.S. CCC SLP
Provider Business Mailing Address
First Line : 8631 SOUTHWESTERN BLVD
Second Line : APT 322
City : DALLAS
State : TX
Zip : 75206-2606
Country : US
Telephone Number : 918-527-7939
Fax Number :
Provider Business Practice Location Address
First Line : 9009 WHITE ROCK TRL
Second Line :
City : DALLAS
State : TX
Zip : 75238-3347
Country : US
Telephone Number : 214-355-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2016
Last Update Date : 01/21/2016

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