Provider Demographics
NPI:1326298142
Name:LIUDAHL, ALISON L (AUD,CCC-A,FAA)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:L
Last Name:LIUDAHL
Suffix:
Gender:F
Credentials:AUD,CCC-A,FAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7657
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22195-7657
Mailing Address - Country:US
Mailing Address - Phone:703-499-8787
Mailing Address - Fax:703-499-8222
Practice Address - Street 1:2070 OLD BRIDGE RD
Practice Address - Street 2:SUITE 103
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2495
Practice Address - Country:US
Practice Address - Phone:703-499-8787
Practice Address - Fax:703-499-8222
Is Sole Proprietor?:No
Enumeration Date:2008-09-29
Last Update Date:2008-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001374231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist