Individual
ALYSSA ALLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 S AVE. K, STATION 3, SHROC, PORTALES, NM 88130
(661) 632-6586
Mailing address
1500 S AVE. K, STATION 3, SHROC, PORTALES, NM 88130
(661) 632-6586
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SPA2692
CA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/02/2015
Last updated
01/29/2019
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