Individual
MRS. ALYSE LAUREN MCCUSKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
650 EDISON AVE, PHILADELPHIA, PA 19116-1237
(215) 673-5700
(215) 673-5598
Mailing address
12028 MILLBROOK RD, PHILADELPHIA, PA 19154-3713
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL007908
PA
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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