Individual
ALYSSA ANN ORTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
PEORIA DEVELOPMENTAL CENTER, 2018 W CIMARRON DRIVE, PEORIA, IL 61614-6161
(309) 693-4424
Mailing address
357 E ELLER DR, EAST PEORIA, IL 61611-5418
(309) 269-6120
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22005711A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
146011140
ILLINOIS SPEECH LANGUAGE PATHOLOGIST LICENSE
IL
Enumeration date
06/27/2013
Last updated
01/18/2019
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