Provider Demographics
NPI:1619283348
Name:PAMPLIN, ALICE ALLEN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALICE
Middle Name:ALLEN
Last Name:PAMPLIN
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 STEVENS MILL RD STE D
Mailing Address - Street 2:SUITE 122
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-3006
Mailing Address - Country:US
Mailing Address - Phone:704-668-1728
Mailing Address - Fax:
Practice Address - Street 1:9421 BETHESDA CT
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-2993
Practice Address - Country:US
Practice Address - Phone:704-668-1728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7197235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist