Provider Demographics
NPI:1114120409
Name:MASON, ALLISON OWENS (MT-BC, CCLS)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:OWENS
Last Name:MASON
Suffix:
Gender:F
Credentials:MT-BC, CCLS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 WHITE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-7781
Mailing Address - Country:US
Mailing Address - Phone:910-796-0648
Mailing Address - Fax:
Practice Address - Street 1:2208 WHITE RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-7781
Practice Address - Country:US
Practice Address - Phone:910-796-0648
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
07990225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist