Provider Demographics
NPI:1457789232
Name:BONNETTE, ALLISON RAND (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:RAND
Last Name:BONNETTE
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 HIGHCREST LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7722
Mailing Address - Country:US
Mailing Address - Phone:864-414-4181
Mailing Address - Fax:
Practice Address - Street 1:581 NEWBERRY HWY
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-7808
Practice Address - Country:US
Practice Address - Phone:864-445-2146
Practice Address - Fax:864-803-0707
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5018235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist