Provider Demographics
NPI:1174779839
Name:TRUMPORE, ALISON RICKEY (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:RICKEY
Last Name:TRUMPORE
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:
Other - Last Name:RICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3974 N PARK OAKS DR
Mailing Address - Street 2:#9
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-5022
Mailing Address - Country:US
Mailing Address - Phone:785-375-7050
Mailing Address - Fax:
Practice Address - Street 1:2474 E JOYCE BLVD
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4519
Practice Address - Country:US
Practice Address - Phone:785-375-7050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist