Provider Demographics
NPI:1003078858
Name:SMITH, ALLISON DAWN (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:DAWN
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:815 E WARNER RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-0994
Mailing Address - Country:US
Mailing Address - Phone:480-963-5800
Mailing Address - Fax:480-963-5805
Practice Address - Street 1:815 E WARNER RD
Practice Address - Street 2:SUITE 106
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0994
Practice Address - Country:US
Practice Address - Phone:480-963-5800
Practice Address - Fax:480-963-5805
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZSLP5874235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist