Provider Demographics
NPI:1396167383
Name:KELLER, ALLYSON PARDEN (MS, CCC-A, FAAA)
Entity type:Individual
Prefix:MRS
First Name:ALLYSON
Middle Name:PARDEN
Last Name:KELLER
Suffix:
Gender:F
Credentials:MS, CCC-A, FAAA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-7404
Mailing Address - Country:US
Mailing Address - Phone:813-240-1551
Mailing Address - Fax:
Practice Address - Street 1:1000 OCHSNER BLVD
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-8107
Practice Address - Country:US
Practice Address - Phone:985-875-2816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-10
Last Update Date:2015-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4247237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter