Provider Demographics
NPI:1184195737
Name:ALLISON'S THERAPY CORNER, LLC
Entity Type:Organization
Organization Name:ALLISON'S THERAPY CORNER, LLC
Other - Org Name:ALLISON'S THERAPY CORNER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:N
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:817-734-6515
Mailing Address - Street 1:3933 VISTA GREENS DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76244-8165
Mailing Address - Country:US
Mailing Address - Phone:817-734-6515
Mailing Address - Fax:
Practice Address - Street 1:630 STONEGLEN DR STE B
Practice Address - Street 2:
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-3626
Practice Address - Country:US
Practice Address - Phone:817-734-6515
Practice Address - Fax:817-717-8584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-07
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty