Provider Demographics
NPI:1699065250
Name:RYAN, ALISSA (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:RYAN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:CRINGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:285 CENTRAL ST STE 217B
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-6144
Mailing Address - Country:US
Mailing Address - Phone:978-212-9616
Mailing Address - Fax:978-849-8393
Practice Address - Street 1:285 CENTRAL ST STE 217B
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-6144
Practice Address - Country:US
Practice Address - Phone:978-212-9616
Practice Address - Fax:978-849-8393
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7808235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist