Provider Demographics
NPI:1144255811
Name:CALDWELL, ALLISON MITCHELL (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:MITCHELL
Last Name:CALDWELL
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 1:8220 CHARRINGTON FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32312-4215
Mailing Address - Country:US
Mailing Address - Phone:850-504-0553
Mailing Address - Fax:850-504-0553
Practice Address - Street 1:8220 CHARRINGTON FOREST BLVD
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32312-4215
Practice Address - Country:US
Practice Address - Phone:850-504-0553
Practice Address - Fax:850-504-0553
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 8096235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890260700Medicaid
FL8122504 00Medicaid