Provider Demographics
NPI:1346070323
Name:FULLER, ALLISON MAE (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MAE
Last Name:FULLER
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:BRINKHOFF
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 N SHORE DR APT 522
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15212-5835
Mailing Address - Country:US
Mailing Address - Phone:412-328-6432
Mailing Address - Fax:
Practice Address - Street 1:220 N SHORE DR APT 522
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15212-5835
Practice Address - Country:US
Practice Address - Phone:412-328-6432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD11183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist