Provider Demographics
NPI:1144381922
Name:TERRELL, ALLISON KIRKLAND (MS CCC A)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:KIRKLAND
Last Name:TERRELL
Suffix:
Gender:F
Credentials:MS CCC A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5147 N 9TH AVE
Mailing Address - Street 2:MEDICAL MALL STE. 315
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-8771
Mailing Address - Country:US
Mailing Address - Phone:850-473-0112
Mailing Address - Fax:850-473-0118
Practice Address - Street 1:5147 N 9TH AVE
Practice Address - Street 2:MEDICAL MALL STE. 315
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-8771
Practice Address - Country:US
Practice Address - Phone:850-473-0112
Practice Address - Fax:850-473-0118
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2011-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL862A231H00000X
FLAY1662231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51500071OtherBCBS PROVIDER NUMBER
AL009940860Medicaid
AL51500071OtherBCBS PROVIDER NUMBER