Alisa Lynn Ruggiero, M.S. CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · East Granby, CT

NPI 1972709202 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1972709202
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
003052 (CT)
Practice address
14 Seneca Dr
East Granby, CT 06026-9772
Phone
(860) 413-9157
NPI assigned
Jun 24, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
003052CTMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 003052 CT Yes

Addresses

Primary practice location

14 Seneca Dr
East Granby, CT 06026-9772

Mailing address

14 Seneca Dr
East Granby, CT 06026-9772
Phone (860) 413-9157

Other providers in East Granby, CT

All providers in East Granby, CT · Speech-Language Pathologist in Connecticut

Sources for this page

Verify at the official NPI Registry.