Basic Information
Provider Information
NPI: 1700593969
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMRICK
FirstName: ALLISON
MiddleName: LEIGH
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 MARCUS DR STE 102
Address2:  
City: GREENVILLE
State: SC
PostalCode: 296154818
CountryCode: US
TelephoneNumber: 8642443626
FaxNumber:  
Practice Location
Address1: 401 N MORGAN ST
Address2:  
City: SHELBY
State: NC
PostalCode: 281504434
CountryCode: US
TelephoneNumber: 7044827326
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/27/2022
LastUpdateDate: 10/27/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/27/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X13939NCY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


Home