Provider Demographics
NPI:1528365350
Name:GRAGSON, ALISON
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:GRAGSON
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 1:1531 E SUNSHINE ST
Mailing Address - Street 2:SUITE W-29
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-1240
Mailing Address - Country:US
Mailing Address - Phone:417-827-8299
Mailing Address - Fax:
Practice Address - Street 1:1531 E SUNSHINE ST
Practice Address - Street 2:SUITE W-29
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-1213
Practice Address - Country:US
Practice Address - Phone:417-827-8299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-14
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health