Alyssa K Manfredi

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5419 Issued in OK

Practice address

1700 NW Lee Blvd
Lawton, OK 73501

Phone

(580) 355-1616

NPI assigned

Oct 21, 2020

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1811596729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3502 E GORE BLVD APT 10104",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735019023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 NW LEE BLVD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "73501",
            "telephone_number": "580-355-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANFREDI",
        "first_name": "ALYSSA",
        "middle_name": "K",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "5419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Maldonado
• William Malicoat, LPC
• Shelley Anne Malone, M.S. CCC-SLP
• Melina L Maloukis
• Antony Vincent Mancheril, MD
• Joshua Manriquez
• Anthony Mans
• Marc Mantzke
• Patricia Mantzke, LPN
• Randy Manuel

• Speech-Language Pathologist in Lawton, OK
• Providers in Lawton, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.