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NPI Code Detail

MEDICARE: MS. ALLYSON REGINA WILSON SLP

MEDICARE: MS. ALLYSON REGINA WILSON SLP
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
1235Z00000XSpeech-Language Pathologist104102TX

General Provider Information

NPI Number : 1467614552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALLYSON REGINA WILSON SLP
Provider Business Mailing Address
First Line : 4100 ALPHA RD STE 1150
Second Line :
City : DALLAS
State : TX
Zip : 75244-4335
Country : US
Telephone Number : 214-796-3242
Fax Number :
Provider Business Practice Location Address
First Line : 4100 ALPHA RD STE 1150
Second Line :
City : DALLAS
State : TX
Zip : 75244-4335
Country : US
Telephone Number : 214-796-3242
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2008
Last Update Date : 08/28/2013

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Directions to “ MS. ALLYSON REGINA WILSON SLP” Practice Location

Language Start Address Practice Location
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