Provider Demographics
NPI:1255534277
Name:CARSON, ALISON BROOKE (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:ALISON
Middle Name:BROOKE
Last Name:CARSON
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 1:10774 E PLACITA GUAJIRA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85730-5815
Mailing Address - Country:US
Mailing Address - Phone:520-631-8387
Mailing Address - Fax:866-597-1700
Practice Address - Street 1:10774 E PLACITA GUAJIRA
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85730-5815
Practice Address - Country:US
Practice Address - Phone:520-631-8387
Practice Address - Fax:866-597-1700
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP1540235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ913857OtherAHCCCS PROVIDER NUMBER