Provider Demographics
NPI:1811531601
Name:KOVACS, ALYSSA (IDTS)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:KOVACS
Suffix:
Gender:F
Credentials:IDTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11762 PRESERVATION LN
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33498-6233
Mailing Address - Country:US
Mailing Address - Phone:561-245-7300
Mailing Address - Fax:
Practice Address - Street 1:11762 PRESERVATION LN
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33498-6233
Practice Address - Country:US
Practice Address - Phone:561-245-7300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist