Provider Demographics
NPI:1255847919
Name:YARNELL, ALLISON D (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:D
Last Name:YARNELL
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 E ROUTE 66 APT 274
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-6225
Mailing Address - Country:US
Mailing Address - Phone:909-730-5776
Mailing Address - Fax:
Practice Address - Street 1:1490 N CLAREMONT BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-3519
Practice Address - Country:US
Practice Address - Phone:909-626-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2017-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25320235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist