Provider Demographics
NPI:1023590700
Name:MILLER, ALYSSA LOUISE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:LOUISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4290 CALLALILY DR APT E
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45459-7137
Mailing Address - Country:US
Mailing Address - Phone:614-716-8550
Mailing Address - Fax:
Practice Address - Street 1:7300 MCEWEN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45459-3903
Practice Address - Country:US
Practice Address - Phone:937-433-3441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSP.13681OtherOHIO SPEECH AND HEARING PROFESSIONALS BOARD