Provider Demographics
NPI:1285015958
Name:STAPLES, ALLISON (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:STAPLES
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35512 LAWS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21850-2100
Mailing Address - Country:US
Mailing Address - Phone:570-872-4304
Mailing Address - Fax:
Practice Address - Street 1:617 FRANKLIN AVE # 13
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:MD
Practice Address - Zip Code:21811-1358
Practice Address - Country:US
Practice Address - Phone:443-402-6072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MD08719235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist