Provider Demographics
NPI:1356497671
Name:QUINN LARKIN, ALISON R (MA CCC SLP)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:R
Last Name:QUINN LARKIN
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 1:206 DUTCHER ST
Mailing Address - Street 2:
Mailing Address - City:HOPEDALE
Mailing Address - State:MA
Mailing Address - Zip Code:01747-1027
Mailing Address - Country:US
Mailing Address - Phone:617-755-6503
Mailing Address - Fax:
Practice Address - Street 1:206 DUTCHER ST
Practice Address - Street 2:
Practice Address - City:HOPEDALE
Practice Address - State:MA
Practice Address - Zip Code:01747-1027
Practice Address - Country:US
Practice Address - Phone:617-755-6503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MASP 0024OtherBCBS