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1083711543
AILISSA ALSUP
CABOT, AR
NPI
1083711543
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: AR SP#1218)
Enumeration Date
2006-09-19
Last Update Date
2007-07-09
Business Address
-- AILISSA ALSUP MS, CCC-SLP
205 PLAZA BLVD.
CABOT, AR 72023
Phone number: 501-628-0063
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Mailing Address
-- AILISSA ALSUP MS, CCC-SLP
P.O. BOX 980
LONOKE, AR 72086
Phone number: 501-676-2786
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