Doctor Name: | ALYSSA ROUSSEAU |
NPI Number: | 1972970333 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 3846 |
Business Practice Address: | 10000 W 75th St Suite 121 Shawnee Mission, KS - 662042209 |
Business Phone Number: | 9133627518 |
Business Fax Number: | 9133627302 |
Mailing Address: | 22814 W 44th St, SHAWNEE |
State: | KS |
Postal Code: | 662262515 |
Phone Number: | 3165184180 |
Fax Number: | |
NPI Enumeration Date: | 09/01/2015 |
NPI Last Update Date: | 09/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3846 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
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 |