Provider Demographics
NPI:1003246356
Name:SPRINGLE, ALISHA PLUNKETT (PHD, CCC-SLP, BCS-CL)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:PLUNKETT
Last Name:SPRINGLE
Suffix:
Gender:F
Credentials:PHD, CCC-SLP, BCS-CL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2411 HARWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46614-9145
Mailing Address - Country:US
Mailing Address - Phone:937-638-1130
Mailing Address - Fax:
Practice Address - Street 1:2411 HARWOOD ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46614-9145
Practice Address - Country:US
Practice Address - Phone:937-638-1130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-23
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 11934235Z00000X
OHSP 5892235Z00000X
IN22007510A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist