Provider Demographics
NPI:1093250656
Name:SOCIAS, ALLISON
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SOCIAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4051 SW 70TH TER
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3165
Mailing Address - Country:US
Mailing Address - Phone:954-864-3049
Mailing Address - Fax:954-442-9150
Practice Address - Street 1:3335 N UNIVERSITY DR STE 5
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-2200
Practice Address - Country:US
Practice Address - Phone:954-442-9422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-05
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLS220-010-95-762-0247200000X
FLSZ9928235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other