MEDICARE: ALLISON MORMANN

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	2005019579	MO
2	235Z00000X	Speech-Language Pathologist	002403	IA

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

General Provider Information

NPI Number	:	1639390180
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON MORMANN

Provider Business Mailing Address
First Line	:	10423 202ND AVE
Second Line	:
City	:	ANAMOSA
State	:	IA
Zip	:	52205-7894
Country	:	US
Telephone Number	:	417-840-8806
Fax Number	:

Provider Business Practice Location Address
First Line	:	2461 10TH ST STE 203
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-1201
Country	:	US
Telephone Number	:	319-358-6323
Fax Number	:

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

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	10/29/2013

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Directions to “ ALLISON MORMANN ” Practice Location

Language	Start Address	Practice Location

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