Provider Demographics
NPI:1306688031
Name:MABRY, ALLISON (AUD)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:MABRY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10700 N RODNEY PARHAM RD STE A7
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-4159
Mailing Address - Country:US
Mailing Address - Phone:501-225-6060
Mailing Address - Fax:
Practice Address - Street 1:10700 N RODNEY PARHAM RD STE A7
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-4159
Practice Address - Country:US
Practice Address - Phone:501-225-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-12
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR202706231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty