Provider Demographics
NPI:1356518716
Name:PIERCE, ALLISON MARIE MULFORD (SLP)
Entity type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:MARIE MULFORD
Last Name:PIERCE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11031 COLOMBUS DR
Mailing Address - Street 2:
Mailing Address - City:FERRYVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54628-8106
Mailing Address - Country:US
Mailing Address - Phone:608-648-3923
Mailing Address - Fax:
Practice Address - Street 1:507 S MAIN ST
Practice Address - Street 2:
Practice Address - City:VIROQUA
Practice Address - State:WI
Practice Address - Zip Code:54665-2059
Practice Address - Country:US
Practice Address - Phone:608-637-4393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-14
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2830-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist