Provider Demographics
NPI:1851845887
Name:HALL, ALISSA BELMONT (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:BELMONT
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:BELMONT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5462 80TH AVENUE CIR E
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:FL
Mailing Address - Zip Code:34221-9159
Mailing Address - Country:US
Mailing Address - Phone:407-463-0502
Mailing Address - Fax:
Practice Address - Street 1:5462 80TH AVENUE CIR E
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:FL
Practice Address - Zip Code:34221-9159
Practice Address - Country:US
Practice Address - Phone:407-463-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-08
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA14590222Q00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist