Provider Demographics
NPI:1538745575
Name:ROMAN, ALYSSA (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:ROMAN
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 1:153 RYLIE DR
Mailing Address - Street 2:
Mailing Address - City:HARMONY
Mailing Address - State:PA
Mailing Address - Zip Code:16037-7765
Mailing Address - Country:US
Mailing Address - Phone:724-462-6028
Mailing Address - Fax:
Practice Address - Street 1:153 RYLIE DR
Practice Address - Street 2:
Practice Address - City:HARMONY
Practice Address - State:PA
Practice Address - Zip Code:16037-7765
Practice Address - Country:US
Practice Address - Phone:724-462-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-21
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013985235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist