Healthcare Provider Details

I. General information

NPI: 1568023463
Provider Name (Legal Business Name): ALLISON NELSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2019
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 W FRONTIER PKWY STE 110
PROSPER TX
75078-3195
US

IV. Provider business mailing address

1429 GREEN VALLEY WAY
CELINA TX
75009-6570
US

V. Phone/Fax

Practice location:
  • Phone: 469-297-6340
  • Fax:
Mailing address:
  • Phone: 972-639-8082
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: