Provider Demographics
NPI:1831504463
Name:BALGORD, ALLENE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALLENE
Middle Name:
Last Name:BALGORD
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 1:2006 S COBBLESTONE CV
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:MS
Mailing Address - Zip Code:39042-2087
Mailing Address - Country:US
Mailing Address - Phone:601-966-1626
Mailing Address - Fax:
Practice Address - Street 1:25 PINE CONE DR
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-8423
Practice Address - Country:US
Practice Address - Phone:386-264-6867
Practice Address - Fax:800-796-0926
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSS3752235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist