MEDICARE: ALYSSA YEE 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
1	235Z00000X	Speech-Language Pathologist	14148830	CO

General Provider Information

NPI Number	:	1881243186
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA YEE CCC-SLP

Provider Business Mailing Address
First Line	:	303 E PLUM ST
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80524-3328
Country	:	US
Telephone Number	:	925-785-7052
Fax Number	:

Provider Business Practice Location Address
First Line	:	4824 S LEMAY AVE
Second Line	:
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-9402
Country	:	US
Telephone Number	:	970-482-1584
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2019
Last Update Date	:	09/09/2019

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Directions to “ ALYSSA YEE CCC-SLP” Practice Location

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