Provider Demographics
NPI:1124840319
Name:GRAY, ALLISON (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:BORGES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:264 OLD FALL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02777-4004
Mailing Address - Country:US
Mailing Address - Phone:774-319-6795
Mailing Address - Fax:
Practice Address - Street 1:538 WILBUR AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:MA
Practice Address - Zip Code:02777-2127
Practice Address - Country:US
Practice Address - Phone:508-488-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01931235Z00000X
MASLP101418235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist