MEDICARE: MS. ALLISON LYNN CONGDON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	6854	NC

General Provider Information

NPI Number	:	1548237290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALLISON LYNN CONGDON

Provider Business Mailing Address
First Line	:	10404 CARVER FALL RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-1469
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10404 CARVER FALL RD
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-1469
Country	:	US
Telephone Number	:	843-532-5823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	07/08/2007

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Directions to “ MS. ALLISON LYNN CONGDON ” Practice Location

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