Provider Demographics
NPI:1871962035
Name:ALLARD, TAMMY (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:TAMMY
Middle Name:
Last Name:ALLARD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 CRICKET CT
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-2703
Mailing Address - Country:US
Mailing Address - Phone:203-752-6235
Mailing Address - Fax:
Practice Address - Street 1:45 MALTBY ST
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-3328
Practice Address - Country:US
Practice Address - Phone:203-924-6225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004796235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist