Provider Demographics
NPI:1073966107
Name:MEZO, ALLISON (CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MEZO
Suffix:
Gender:F
Credentials:CF-SLP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:BIDDINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4154 HAWTHORNE RDG
Mailing Address - Street 2:APT 101
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49006-6295
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4154 HAWTHORNE RDG
Practice Address - Street 2:APT 101
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49006-6295
Practice Address - Country:US
Practice Address - Phone:989-912-0494
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101005212235Z00000X
MI0235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist