Provider Demographics
NPI:1538248331
Name:HASKELL, ALLISON DUNN (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:DUNN
Last Name:HASKELL
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Gender:F
Credentials:SPEECH PATHOLOGIST
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Mailing Address - Street 1:190 112TH AVE N
Mailing Address - Street 2:APT 1213
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33716-3277
Mailing Address - Country:US
Mailing Address - Phone:727-398-6661
Mailing Address - Fax:727-319-1209
Practice Address - Street 1:10000 BAY PINES BLVD
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33708
Practice Address - Country:US
Practice Address - Phone:727-398-6661
Practice Address - Fax:727-319-1209
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSA 8466235Z00000X
OHSP08947235Z00000X
KY246363235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL890854100Medicaid