Provider Demographics
NPI:1982383691
Name:ATOR, ALISON J (SLP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:J
Last Name:ATOR
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:921 4TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-2427
Mailing Address - Country:US
Mailing Address - Phone:402-470-1228
Mailing Address - Fax:
Practice Address - Street 1:401 PRAIRIE AVE NE
Practice Address - Street 2:
Practice Address - City:STAPLES
Practice Address - State:MN
Practice Address - Zip Code:56479-3201
Practice Address - Country:US
Practice Address - Phone:218-634-3488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN528594235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist