Provider Demographics
NPI:1467024273
Name:SALEMA, ALLISON (SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:SALEMA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01850-1291
Mailing Address - Country:US
Mailing Address - Phone:978-459-7711
Mailing Address - Fax:
Practice Address - Street 1:1230 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01850-1291
Practice Address - Country:US
Practice Address - Phone:978-459-7711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST3517235Z00000X
MA78684-SP-SL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA78684-SP-SLOtherSTATE LICENSE