Healthcare Provider Details

I. General information

NPI: 1467362848
Provider Name (Legal Business Name): ALAYNA MASON COLVIN CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALAYNA MASON

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 HERGOT STREET #10168
RUSTON LA
71272-0001
US

IV. Provider business mailing address

168 BUCK MEADOW DR
RUSTON LA
71270-7445
US

V. Phone/Fax

Practice location:
  • Phone: 318-257-3469
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number7678
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: