Provider Demographics
NPI:1003160102
Name:KLUCHER, ALISON M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:KLUCHER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 LITTLEDALE RD
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-3424
Mailing Address - Country:US
Mailing Address - Phone:301-946-7700
Mailing Address - Fax:
Practice Address - Street 1:3620 LITTLEDALE RD
Practice Address - Street 2:
Practice Address - City:KENSINGTON
Practice Address - State:MD
Practice Address - Zip Code:20895-3424
Practice Address - Country:US
Practice Address - Phone:301-946-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-29
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07098235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist