Provider Demographics
NPI:1245425909
Name:ALLISON, MARY BETH GEGLIA (MS)
Entity type:Individual
Prefix:MRS
First Name:MARY BETH
Middle Name:GEGLIA
Last Name:ALLISON
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 1:1787 SW SEA HOLLY WAY
Mailing Address - Street 2:
Mailing Address - City:PALM CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34990-8532
Mailing Address - Country:US
Mailing Address - Phone:964-732-6415
Mailing Address - Fax:
Practice Address - Street 1:1787 SW SEA HOLLY WAY
Practice Address - Street 2:
Practice Address - City:PALM CITY
Practice Address - State:FL
Practice Address - Zip Code:34990-8532
Practice Address - Country:US
Practice Address - Phone:964-732-6415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8831235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist