Provider Demographics
NPI:1528031572
Name:CROXTON, ALLISON K (MSP, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:K
Last Name:CROXTON
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 ELM AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29205-4546
Mailing Address - Country:US
Mailing Address - Phone:803-400-1231
Mailing Address - Fax:803-400-1231
Practice Address - Street 1:1101 ELM AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29205-4546
Practice Address - Country:US
Practice Address - Phone:803-400-1231
Practice Address - Fax:803-400-1231
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-09
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4272235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200392560Medicaid