Provider Demographics
NPI:1073947339
Name:BAUER, ALLISON BROOKE (MS, CCC-SLP, TSSLD)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:BROOKE
Last Name:BAUER
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 MAIN ST
Mailing Address - Street 2:APT 1218
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0105
Mailing Address - Country:US
Mailing Address - Phone:732-995-6562
Mailing Address - Fax:
Practice Address - Street 1:65 COURT ST
Practice Address - Street 2:ROOM 201
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-4916
Practice Address - Country:US
Practice Address - Phone:718-935-4000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-22
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023110235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist