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Individual

ALLISON DIANE TRASK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CCC-SLP

Contact information

Practice address
4205 WILDCAT DR, CORPUS CHRISTI, TX 78410-5108
(361) 242-5600
Mailing address
3609 LAKE PALESTINE, ROBSTOWN, TX 78380-6144

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
111622
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111622
TDLR
TX
Enumeration date
03/11/2022
Last updated
03/11/2022
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