Provider Demographics
NPI:1770681249
Name:KESTER, ALLISON WAHL (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:WAHL
Last Name:KESTER
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 1:22834 HONEYSUCKLE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-7501
Mailing Address - Country:US
Mailing Address - Phone:864-386-1359
Mailing Address - Fax:
Practice Address - Street 1:22834 HONEYSUCKLE RD
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-7501
Practice Address - Country:US
Practice Address - Phone:864-386-1359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC373282Medicaid
SC373282Medicaid