Provider Demographics
NPI:1457899197
Name:TERRY, ALISON SIRES (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:SIRES
Last Name:TERRY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 MUSKET LOOP
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8985
Mailing Address - Country:US
Mailing Address - Phone:843-607-1584
Mailing Address - Fax:
Practice Address - Street 1:624 HOLLY SPRINGS RD # 314
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-9030
Practice Address - Country:US
Practice Address - Phone:843-607-1584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4874235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist