Provider Demographics
NPI:1073057527
Name:ABELIAN, ALLISON BYRNES (MED, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:BYRNES
Last Name:ABELIAN
Suffix:
Gender:F
Credentials:MED, CCC-SLP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:FAYE
Other - Last Name:BYRNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2556 KNOX CT
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-4139
Mailing Address - Country:US
Mailing Address - Phone:502-759-5853
Mailing Address - Fax:
Practice Address - Street 1:101 E REDLANDS BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4775
Practice Address - Country:US
Practice Address - Phone:909-735-7654
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASP21128235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist