Provider Demographics
NPI:1104901966
Name:AMSHOFF, ALISON RENEE (SLP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:RENEE
Last Name:AMSHOFF
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:RENEE
Other - Last Name:GUMM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:845 SOUTH 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40203
Mailing Address - Country:US
Mailing Address - Phone:502-873-4211
Mailing Address - Fax:502-873-4211
Practice Address - Street 1:845 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40203-2213
Practice Address - Country:US
Practice Address - Phone:502-873-4211
Practice Address - Fax:502-873-4211
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-2900235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9517Medicare ID - Type UnspecifiedGROUP NUMBER