Provider Demographics
NPI:1588212435
Name:HINES, ALLISON CARROLL (MCD CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:CARROLL
Last Name:HINES
Suffix:
Gender:F
Credentials:MCD CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 PEBBLEBRANCH DRIVE
Mailing Address - Street 2:
Mailing Address - City:CHAPIN
Mailing Address - State:SC
Mailing Address - Zip Code:29036
Mailing Address - Country:US
Mailing Address - Phone:803-800-1814
Mailing Address - Fax:
Practice Address - Street 1:160 PEBBLEBRANCH DRIVE
Practice Address - Street 2:
Practice Address - City:CHAPIN
Practice Address - State:SC
Practice Address - Zip Code:29036
Practice Address - Country:US
Practice Address - Phone:803-800-1814
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-03
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
SC7015235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist