Provider Demographics
NPI:1275037160
Name:MERRELL, ALLISON (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MERRELL
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 1:165 TARA CT
Mailing Address - Street 2:
Mailing Address - City:FORSYTH
Mailing Address - State:MO
Mailing Address - Zip Code:65653-5367
Mailing Address - Country:US
Mailing Address - Phone:417-546-2235
Mailing Address - Fax:
Practice Address - Street 1:178 PANTHER ST
Practice Address - Street 2:
Practice Address - City:FORSYTH
Practice Address - State:MO
Practice Address - Zip Code:65653-5387
Practice Address - Country:US
Practice Address - Phone:417-546-6381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-23
Last Update Date:2018-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist