Provider Demographics
NPI:1184896136
Name:NEEDLEMAN, ALYSSA R (PHD)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:R
Last Name:NEEDLEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3200 S UNIVERSITY DR
Mailing Address - Street 2:DEPARTMENT OF AUDIOLOGY
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2018
Mailing Address - Country:US
Mailing Address - Phone:954-262-7764
Mailing Address - Fax:954-262-3987
Practice Address - Street 1:3200 S UNIVERSITY DR
Practice Address - Street 2:DEPARTMENT OF AUDIOLOGY
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-7764
Practice Address - Fax:954-262-3987
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-31
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2582231H00000X
FLAY1839231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist