Provider Demographics
NPI:1386070381
Name:HALSTEAD, ALYSON ELAINE (CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:ALYSON
Middle Name:ELAINE
Last Name:HALSTEAD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-1815
Mailing Address - Country:US
Mailing Address - Phone:717-385-7813
Mailing Address - Fax:
Practice Address - Street 1:1610 FOREST AVE
Practice Address - Street 2:214
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-5009
Practice Address - Country:US
Practice Address - Phone:804-282-4596
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006357235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist