Provider Demographics
NPI:1588344105
Name:ALLRED, AVERY (SLT)
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:
Last Name:ALLRED
Suffix:
Gender:F
Credentials:SLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 E 500 S UNIT B
Mailing Address - Street 2:
Mailing Address - City:AMERICAN FORK
Mailing Address - State:UT
Mailing Address - Zip Code:84003-3065
Mailing Address - Country:US
Mailing Address - Phone:385-472-4102
Mailing Address - Fax:
Practice Address - Street 1:3444 W 3000 S
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-3982
Practice Address - Country:US
Practice Address - Phone:435-654-1347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant