Provider Demographics
NPI:1205511284
Name:SCALES, ALLISON NICOLE (MT)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:NICOLE
Last Name:SCALES
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25624 THELMADALE DR
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46514-6203
Mailing Address - Country:US
Mailing Address - Phone:574-326-4756
Mailing Address - Fax:574-318-7839
Practice Address - Street 1:229 RED COACH DR STE 106
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3195
Practice Address - Country:US
Practice Address - Phone:574-318-7800
Practice Address - Fax:574-318-7839
Is Sole Proprietor?:No
Enumeration Date:2023-06-19
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist