Provider Demographics
NPI:1063053205
Name:BIGELOW, ALYSSA RENEE (MS,ED)
Entity type:Individual
Prefix:MRS
First Name:ALYSSA
Middle Name:RENEE
Last Name:BIGELOW
Suffix:
Gender:F
Credentials:MS,ED
Other - Prefix:MISS
Other - First Name:ALYSSA
Other - Middle Name:RENEE
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS ED
Mailing Address - Street 1:709 E DEKALB RD
Mailing Address - Street 2:
Mailing Address - City:DE KALB JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:13630-3103
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:709 E DEKALB RD
Practice Address - Street 2:
Practice Address - City:DE KALB JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:13630-3103
Practice Address - Country:US
Practice Address - Phone:315-347-3442
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-30
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029156-01235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist