Provider Demographics
NPI:1003215641
Name:GEDDES, ALANA
Entity Type:Individual
Prefix:MRS
First Name:ALANA
Middle Name:
Last Name:GEDDES
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ALANA
Other - Middle Name:
Other - Last Name:ELLERBROCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5086 SPRINGDALE BLVD
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-9269
Mailing Address - Country:US
Mailing Address - Phone:419-231-1213
Mailing Address - Fax:
Practice Address - Street 1:2000 W STANFIELD RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-2572
Practice Address - Country:US
Practice Address - Phone:937-339-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2014-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 11319235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist