| Doctor Name: | ALYSSA LORD |
| NPI Number: | 1083091078 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S. |
| License Number: | C-5655 |
| Business Practice Address: | 2211 Lomas Blvd. Ne Sls Center - 3rd Floor Albuquerque, NM - 87102 |
| Business Phone Number: | 5052720777 |
| Business Fax Number: | |
| Mailing Address: | 5741 Osuna Rd Ne, Apt 708 ALBUQUERQUE |
| State: | NM |
| Postal Code: | 871092567 |
| Phone Number: | 6177592918 |
| Fax Number: | |
| NPI Enumeration Date: | 04/29/2015 |
| NPI Last Update Date: | 04/29/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | C-5655 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| 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 |