Provider Demographics
NPI:1962632133
Name:BAKER, ALLISON LONG (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:LONG
Last Name:BAKER
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 1:22 AUDUBON LN
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:RI
Mailing Address - Zip Code:02831-1627
Mailing Address - Country:US
Mailing Address - Phone:401-499-3311
Mailing Address - Fax:
Practice Address - Street 1:30 PIEDMONT AVE
Practice Address - Street 2:
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451-3013
Practice Address - Country:US
Practice Address - Phone:781-367-0841
Practice Address - Fax:781-373-1899
Is Sole Proprietor?:No
Enumeration Date:2009-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00917235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist