Provider Demographics
NPI:1154820843
Name:CONNELL, ALISON ANN (SLP)
Entity Type:Individual
Prefix:MISS
First Name:ALISON
Middle Name:ANN
Last Name:CONNELL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3910 DOC BERLIN DR UNIT 12
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1185
Mailing Address - Country:US
Mailing Address - Phone:240-338-5556
Mailing Address - Fax:
Practice Address - Street 1:2092 GAITHER RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-4016
Practice Address - Country:US
Practice Address - Phone:301-424-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD08242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist