Clark, Alyssa
Clark, Alyssa is an individual health care provider with primary practice located at 245 N Metro Dr , Appleton WI 54913-8572. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Music Therapist, which is considered as her primary health care specialty. Clark, Alyssa can be contacted via phone (920) 903-1009.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Music Therapist | 225A00000X | 12186 |
Profile Details
| NPI number | 1104400175 |
|---|---|
| LBN Legal business name | Clark, Alyssa |
| Credentials | MT-BC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 6th, 2021 |
| Last updated | May 6th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104400175 | NPPES |
| Other | 12186 | CBMT |
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