Provider Demographics
NPI:1346934254
Name:PHILLIPS, ALLISON PAIGE
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:PAIGE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16741 HIGHWAY 67 STE E
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-2529
Mailing Address - Country:US
Mailing Address - Phone:912-235-6603
Mailing Address - Fax:
Practice Address - Street 1:16741 HIGHWAY 67 STE E
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-2529
Practice Address - Country:US
Practice Address - Phone:912-235-6603
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHADS001056237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist