MEDICARE: ALLISON LANDERS MOSS 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
1	235Z00000X	Speech-Language Pathologist	SP # 1285	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	5W259	OTHER	AR	BCBS

General Provider Information

NPI Number	:	1558425777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON LANDERS MOSS SLP

Provider Business Mailing Address
First Line	:	3291 S THOMPSON ST STE F101
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72764-7342
Country	:	US
Telephone Number	:	479-750-3535
Fax Number	:	479-750-3539

Provider Business Practice Location Address
First Line	:	3291 S THOMPSON ST STE F101
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72764-7342
Country	:	US
Telephone Number	:	479-750-3535
Fax Number	:	479-750-3539

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

Provider Enumeration Date	:	12/21/2006
Last Update Date	:	10/07/2024

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Directions to “ ALLISON LANDERS MOSS SLP” Practice Location

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