Provider Demographics
NPI:1922725530
Name:AGULNICK, ALLISON (AUD)
Entity Type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:AGULNICK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 N CAUSEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-3104
Mailing Address - Country:US
Mailing Address - Phone:985-273-5795
Mailing Address - Fax:
Practice Address - Street 1:1258 BROWNSWITCH RD
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-1605
Practice Address - Country:US
Practice Address - Phone:985-273-5795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9107231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist