Provider Demographics
NPI:1780883173
Name:FARRELL, ALLISON HAMPTON (AUD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:HAMPTON
Last Name:FARRELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 CENTRAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2069
Mailing Address - Country:US
Mailing Address - Phone:817-261-9191
Mailing Address - Fax:817-784-6880
Practice Address - Street 1:409 CENTRAL PARK DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76014-2069
Practice Address - Country:US
Practice Address - Phone:817-261-9191
Practice Address - Fax:817-784-6880
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2020-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
TX60526231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB116022Medicare PIN