Provider Demographics
NPI:1023278066
Name:KOWALCZYK, ALLISON RAE (MS)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:RAE
Last Name:KOWALCZYK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:496 1ST ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-3676
Mailing Address - Country:US
Mailing Address - Phone:650-941-0664
Mailing Address - Fax:650-941-2892
Practice Address - Street 1:496 1ST ST
Practice Address - Street 2:SUITE 120
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-3676
Practice Address - Country:US
Practice Address - Phone:650-941-0664
Practice Address - Fax:650-941-2892
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPE 4611231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist