Provider Demographics
NPI:1073139572
Name:DELK-PECK, ALISON NICHOLE
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:NICHOLE
Last Name:DELK-PECK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:NICHOLE
Other - Last Name:HALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1975 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:KINGMAN
Mailing Address - State:AZ
Mailing Address - Zip Code:86401-4134
Mailing Address - Country:US
Mailing Address - Phone:928-846-7311
Mailing Address - Fax:
Practice Address - Street 1:4995 US HIGHWAY 68
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86413-5500
Practice Address - Country:US
Practice Address - Phone:928-707-2416
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant