Provider Demographics
NPI:1770842528
Name:GENCO, ALLISON R (MS, CCC-SLP/L)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:R
Last Name:GENCO
Suffix:
Gender:F
Credentials:MS, CCC-SLP/L
Other - Prefix:MS
Other - First Name:ALLISON
Other - Middle Name:R
Other - Last Name:THOMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 HUNT ROAD, W.E.
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:14701
Mailing Address - Country:US
Mailing Address - Phone:716-664-1881
Mailing Address - Fax:716-487-3170
Practice Address - Street 1:600 HUNT ROAD, W.E.
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NY
Practice Address - Zip Code:14701
Practice Address - Country:US
Practice Address - Phone:716-664-1881
Practice Address - Fax:716-487-3170
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2014-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022588-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist