Basic Information
| Provider Information | |||||||||
| NPI: | 1013312636 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAINER | ||||||||
| FirstName: | ALLYSON | ||||||||
| MiddleName: | LEIGH | ||||||||
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| Credential: | AU.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 17167 | ||||||||
| Address2: | |||||||||
| City: | HATTIESBURG | ||||||||
| State: | MS | ||||||||
| PostalCode: | 394047167 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6012615995 | ||||||||
| FaxNumber: | 6012615335 | ||||||||
| Practice Location | |||||||||
| Address1: | 5646 OLD PASCAGOULA RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | MOBILE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 366192134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2516531112 | ||||||||
| FaxNumber: | 2516533128 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/24/2014 | ||||||||
| LastUpdateDate: | 12/30/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 237600000X | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 80715 | TX | N | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | 1160A | AL | Y | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237600000X | A4047 | MS | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter |
No ID Information.