Provider Demographics
NPI:1700197308
Name:HIESTER, ALISON MARIE (MS CCC - SLP)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:MARIE
Last Name:HIESTER
Suffix:
Gender:F
Credentials:MS CCC - SLP
Other - Prefix:MRS
Other - First Name:ALISON
Other - Middle Name:MARIE
Other - Last Name:MUCK-GRAHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS CCC - SLP
Mailing Address - Street 1:7600 CHEVY CHASE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-1599
Mailing Address - Country:US
Mailing Address - Phone:512-399-0064
Mailing Address - Fax:
Practice Address - Street 1:102 S TEJON ST STE 1100
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-2253
Practice Address - Country:US
Practice Address - Phone:512-399-0064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL-004-703-L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist