Provider Demographics
NPI:1265240121
Name:DICARO, ALLISON
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:DICARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MOBILE SPEECH AND LANGUAGE THERAPY
Mailing Address - Street 2:178 BRITTANY DRIVE
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728
Mailing Address - Country:US
Mailing Address - Phone:732-241-1303
Mailing Address - Fax:
Practice Address - Street 1:MOBILE SPEECH AND LANGUAGE THERAPY
Practice Address - Street 2:178 BRITTANY DRIVE
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728
Practice Address - Country:US
Practice Address - Phone:732-241-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00806400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty