Provider Demographics
NPI:1982755740
Name:ALFORD, DENISE IRENE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:IRENE
Last Name:ALFORD
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 1:181 JOY CIR
Mailing Address - Street 2:
Mailing Address - City:CAMDENTON
Mailing Address - State:MO
Mailing Address - Zip Code:65020-3813
Mailing Address - Country:US
Mailing Address - Phone:573-434-6269
Mailing Address - Fax:
Practice Address - Street 1:224 W COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:MO
Practice Address - Zip Code:65536-3146
Practice Address - Country:US
Practice Address - Phone:417-657-6001
Practice Address - Fax:417-532-9492
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
MO101665235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1750449823Medicaid
MO463354118Medicaid