Provider Demographics
NPI:1912129800
Name:BROTHERS, ALISON (MA CCC SLP)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:
Last Name:BROTHERS
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1369 OVERLAND DR.
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34608
Mailing Address - Country:US
Mailing Address - Phone:352-200-6902
Mailing Address - Fax:
Practice Address - Street 1:8800 GRAND OAK CIRCLE
Practice Address - Street 2:SUITE 450
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33637
Practice Address - Country:US
Practice Address - Phone:352-397-6525
Practice Address - Fax:813-975-1016
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8286235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist