Provider Demographics
NPI:1649513375
Name:PASTERNACK, ALLYSON HOPE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:HOPE
Last Name:PASTERNACK
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 1:6249 BLACK CREEK LOOP N
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3901
Mailing Address - Country:US
Mailing Address - Phone:205-985-8592
Mailing Address - Fax:
Practice Address - Street 1:3057 LORNA RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35216-4514
Practice Address - Country:US
Practice Address - Phone:205-978-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3344235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist