Provider Demographics
NPI:1972919033
Name:GILLIES, ALISON CLAIRE (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:CLAIRE
Last Name:GILLIES
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:MISS
Other - First Name:ALISON
Other - Middle Name:CLAIRE
Other - Last Name:TANNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC/SLP
Mailing Address - Street 1:3845 RANCH ROAD 2222
Mailing Address - Street 2:UNIT 26
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4877
Mailing Address - Country:US
Mailing Address - Phone:972-658-9163
Mailing Address - Fax:
Practice Address - Street 1:5555 N LAMAR BLVD
Practice Address - Street 2:STE. L 103
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-1073
Practice Address - Country:US
Practice Address - Phone:512-200-2332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-09
Last Update Date:2014-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105323235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist