Provider Demographics
NPI:1013579341
Name:ALLEN, ALLISON (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:ALLEN
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 1:1116 FRAZIER ST
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:AL
Mailing Address - Zip Code:35611
Mailing Address - Country:US
Mailing Address - Phone:256-648-9570
Mailing Address - Fax:
Practice Address - Street 1:102 SANDERS ST
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35611-2418
Practice Address - Country:US
Practice Address - Phone:256-431-4223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist