Provider Demographics
NPI:1902577018
Name:WEBB, ALYSSA (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:
Last Name:WEBB
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23932 STATE HIGHWAY 44
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:96062-9751
Mailing Address - Country:US
Mailing Address - Phone:530-227-2441
Mailing Address - Fax:
Practice Address - Street 1:23932 STATE HIGHWAY 44
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:CA
Practice Address - Zip Code:96062-9751
Practice Address - Country:US
Practice Address - Phone:530-227-2441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28581235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist