Provider Demographics
NPI:1760503510
Name:SALTER, ALLISON (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:SALTER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 SADDLEBROOK CT
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31721-7108
Mailing Address - Country:US
Mailing Address - Phone:229-483-9809
Mailing Address - Fax:
Practice Address - Street 1:2302 SADDLEBROOK CT
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31721-7108
Practice Address - Country:US
Practice Address - Phone:229-483-9809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004392235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00844258BMedicaid