Provider Demographics
NPI:1821350653
Name:MCCLINTOCK, ALLISON KIKU (MA/CCC-SP)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:KIKU
Last Name:MCCLINTOCK
Suffix:
Gender:F
Credentials:MA/CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 KAIULANI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2528
Mailing Address - Country:US
Mailing Address - Phone:808-961-3081
Mailing Address - Fax:
Practice Address - Street 1:49 KAIULANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2528
Practice Address - Country:US
Practice Address - Phone:808-961-3081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI453235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist