Provider Demographics
NPI:1003699935
Name:ROOF, ALISON L
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:L
Last Name:ROOF
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 LASALLE ST APT 3
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-2494
Mailing Address - Country:US
Mailing Address - Phone:567-712-3275
Mailing Address - Fax:
Practice Address - Street 1:84 LASALLE ST APT 3
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44906-2494
Practice Address - Country:US
Practice Address - Phone:567-712-3275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-15
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH15441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist