Basic Information
| Provider Information | |||||||||
| NPI: | 1053790733 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CONLEY | ||||||||
| FirstName: | ALANNA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 45 SOCKANOSSET CROSS RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029205529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787373760 | ||||||||
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| Practice Location | |||||||||
| Address1: | 45 SOCKANOSSET CROSS RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | CRANSTON | ||||||||
| State: | RI | ||||||||
| PostalCode: | 02920 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9787373760 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2015 | ||||||||
| LastUpdateDate: | 09/07/2018 | ||||||||
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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 | 026930 | NY | N | Speech, Language and Hearing Service Providers | Speech-Language Pathologist | 235Z00000X | SP01429 | RI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.