Provider Demographics
NPI:1093588733
Name:ISRAEL, ALLYSON EVA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:ALLYSON
Middle Name:EVA
Last Name:ISRAEL
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3922 COMMON ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-2941
Mailing Address - Country:US
Mailing Address - Phone:318-481-3500
Mailing Address - Fax:
Practice Address - Street 1:3922 COMMON ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-2941
Practice Address - Country:US
Practice Address - Phone:318-481-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-03
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA14479774235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist