Provider Demographics
NPI:1609412055
Name:SURDY, ALISON MARIE (MA)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:MARIE
Last Name:SURDY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 DENWAY DR
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3105
Mailing Address - Country:US
Mailing Address - Phone:269-873-0945
Mailing Address - Fax:
Practice Address - Street 1:1701 OLMSTEAD RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-3343
Practice Address - Country:US
Practice Address - Phone:269-903-0547
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-20
Last Update Date:2019-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor