Basic Information
| Provider Information | |||||||||
| NPI: | 1043432941 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALSUM | ||||||||
| FirstName: | AUBRIE | ||||||||
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| Credential: | MSCCCSLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1106 69TH ST. E. | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 34220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417482956 | ||||||||
| FaxNumber: | 9417298322 | ||||||||
| Practice Location | |||||||||
| Address1: | THE KIDSPOT 410 10TH AVE W. | ||||||||
| Address2: | |||||||||
| City: | PALMETTO | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342215032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417223582 | ||||||||
| FaxNumber: | 9417298322 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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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 | 235Z00000X | SA7102 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.