Provider Demographics
NPI:1780903542
Name:WEIR, ALISON ELIZABETH (BSE)
Entity type:Individual
Prefix:MISS
First Name:ALISON
Middle Name:ELIZABETH
Last Name:WEIR
Suffix:
Gender:F
Credentials:BSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 E SHORT 10TH ST
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:AR
Mailing Address - Zip Code:71854-4932
Mailing Address - Country:US
Mailing Address - Phone:870-772-9815
Mailing Address - Fax:
Practice Address - Street 1:4505 PINSON DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:AR
Practice Address - Zip Code:71854-1650
Practice Address - Country:US
Practice Address - Phone:870-772-8431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-19
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR09-0105235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist