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Individual

ALYSSA TESTIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
1320 STATE ST, OTTAWA, IL 61350-4413
(815) 257-1230
Mailing address
203 N VIA TOMACELLI, TOLUCA, IL 61369-9509

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
242002053
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01134146
RR MEDICARE
IL
Enumeration date
04/24/2012
Last updated
03/17/2018
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