Provider Demographics
NPI:1962808634
Name:BOUQUET, ALLISON (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:BOUQUET
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 1:87 LAFAYETTE RD STE 3
Mailing Address - Street 2:
Mailing Address - City:HAMPTON FALLS
Mailing Address - State:NH
Mailing Address - Zip Code:03844-2300
Mailing Address - Country:US
Mailing Address - Phone:603-926-3277
Mailing Address - Fax:888-519-7585
Practice Address - Street 1:87 LAFAYETTE RD STE 3
Practice Address - Street 2:
Practice Address - City:HAMPTON FALLS
Practice Address - State:NH
Practice Address - Zip Code:03844-2300
Practice Address - Country:US
Practice Address - Phone:603-926-3277
Practice Address - Fax:888-519-7585
Is Sole Proprietor?:No
Enumeration Date:2014-11-07
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1394235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist