Jacqueline Michelle Allen, MS CCCSLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SL00474DL

Practice address

110 Campus Drive
Bradford, PA 16701

Phone

(814) 887-5591

Fax

(814) 887-5666

NPI assigned

Apr 16, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720203706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 83",
            "city": "DISTANT",
            "state": "PA",
            "postal_code": "16223",
            "telephone_number": "814-541-1073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CAMPUS DRIVE",
            "city": "BRADFORD",
            "state": "PA",
            "postal_code": "16701",
            "telephone_number": "814-887-5591",
            "fax_number": "814-887-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JACQUELINE",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MS CCCSLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": "SL00474DL",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001938638000Z",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholle Renee Aiello
• Muhammad Javed Akhtar, MD
• Sayed Shaheer Alamy, MD
• Rebecca L Alborn
• Grant Daniel Allen, PHARMACIST
• Syed A Ally, MD
• Evelyn Anderson, CRNP
• Kelli Anderson, LDN
• Tracy Lynn Andrus, PA-C
• Anesthetix of Bradford, LLC

• Speech-Language Pathologist in Bradford, PA
• Providers in Bradford, PA by specialty
• Speech-Language Pathologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.