Provider Demographics
NPI:1376098236
Name:BOUNDS, ALLISON (CFY/SLP)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:BOUNDS
Suffix:
Gender:F
Credentials:CFY/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 RICE RD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-3022
Mailing Address - Country:US
Mailing Address - Phone:954-510-3693
Mailing Address - Fax:
Practice Address - Street 1:831 RICE RD
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-3022
Practice Address - Country:US
Practice Address - Phone:954-510-3693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-22
Last Update Date:2016-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS4060174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSS4060OtherMS LIC# S4060