Individual
MRS. ALISSA RENEE FRIEDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP, MS-CCC-L
Contact information
Practice address
304 ELM ST, FAYETTEVILLE, NY 13066-1414
(315) 637-2855
Mailing address
304 ELM ST, FAYETTEVILLE, NY 13066-1414
(315) 637-2855
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
014534-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01434959
—
NY
Enumeration date
12/23/2011
Last updated
12/23/2011
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