Basic Information
Provider Information
NPI: 1750642781
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALLONEN-ALLIE
FirstName: NANCY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CCC-A
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ALLONEN
OtherFirstName: NANCY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: CCC-A
OtherLastNameType: 1
Mailing Information
Address1: 888 WORCESTER ST
Address2: SUITE 130
City: WELLESLEY
State: MA
PostalCode: 024823744
CountryCode: US
TelephoneNumber: 6179646681
FaxNumber: 3396862561
Practice Location
Address1: 888 WORCESTER ST
Address2: SUITE 130
City: WELLESLEY
State: MA
PostalCode: 024823744
CountryCode: US
TelephoneNumber: 6179646681
FaxNumber: 3396862561
Other Information
ProviderEnumerationDate: 06/06/2012
LastUpdateDate: 06/06/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X465MAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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