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Individual

ALLYSON WADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
515 CHESAPEAKE DR, TARPON SPRINGS, FL 34689-2515
(727) 934-4629
Mailing address
2600 COMPASS RD, GLENVIEW, IL 60026-8001
(877) 787-3422

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA14786
FL
235Z00000X
Speech-Language Pathologist
SZ7251
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015656900
FL
Enumeration date
09/02/2015
Last updated
08/12/2020
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