Provider Demographics
NPI:1740290196
Name:WEGMAN, ALLISON MARIE (MS)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MARIE
Last Name:WEGMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4450 WALKER BLVD
Mailing Address - Street 2:STE. A
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1547
Mailing Address - Country:US
Mailing Address - Phone:865-686-0082
Mailing Address - Fax:865-686-0174
Practice Address - Street 1:4450 WALKER BLVD
Practice Address - Street 2:STE. A
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1547
Practice Address - Country:US
Practice Address - Phone:865-686-0082
Practice Address - Fax:865-686-0174
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3310235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist