Provider Demographics
NPI:1528304433
Name:SULEY, ALYSHA DAWN (MT-BC)
Entity type:Individual
Prefix:MRS
First Name:ALYSHA
Middle Name:DAWN
Last Name:SULEY
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:91 RAILROAD LN STE 101
Mailing Address - Street 2:
Mailing Address - City:BLOOMSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17815-7458
Mailing Address - Country:US
Mailing Address - Phone:570-316-1899
Mailing Address - Fax:570-243-0228
Practice Address - Street 1:91 RAILROAD LN STE 101
Practice Address - Street 2:
Practice Address - City:BLOOMSBURG
Practice Address - State:PA
Practice Address - Zip Code:17815-7458
Practice Address - Country:US
Practice Address - Phone:570-316-1899
Practice Address - Fax:570-243-0228
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PA10249225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist