Provider Demographics
NPI:1154842474
Name:ESPINOSA, ALLISON WAGNER (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:WAGNER
Last Name:ESPINOSA
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14881 CADILLAC DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-1009
Mailing Address - Country:US
Mailing Address - Phone:210-710-5160
Mailing Address - Fax:
Practice Address - Street 1:16723 HUEBNER RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-2342
Practice Address - Country:US
Practice Address - Phone:210-614-0171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-28
Last Update Date:2017-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL51115231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist