| Doctor Name: | ALISA DANELLE DEMICO |
| NPI Number: | 1023046133 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | SA4664 |
| Business Practice Address: | 9803 Old Saint Augustine Rd Suite 7 Jacksonville, FL - 322578854 |
| Business Phone Number: | 9048809001 |
| Business Fax Number: | 9048809007 |
| Mailing Address: | 6179 Eclipse Cir, JACKSONVILLE |
| State: | FL |
| Postal Code: | 322588434 |
| Phone Number: | 9045348111 |
| Fax Number: | 9048809007 |
| NPI Enumeration Date: | 06/29/2006 |
| NPI Last Update Date: | 12/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SA4664 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |