=====================================================
General NPI Number Information
=====================================================
NPI Number | 1265240121
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALLISON DICARO
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/24/2024
-----------------------------------------------------
Last Update Date | 12/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MOBILE SPEECH AND LANGUAGE THERAPY 178 BRITTANY DRIVE
-----------------------------------------------------
City | FREEHOLD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-241-1303
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | MOBILE SPEECH AND LANGUAGE THERAPY 178 BRITTANY DRIVE
-----------------------------------------------------
City | FREEHOLD
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 732-241-1303
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 41YS00806400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------