MRS. ALISHA PUCKETT (NPI# 1225115850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1225115850 |
| Entity Type | Individual |
| Full Name | MRS. ALISHA PUCKETT |
| Other Name | MISS ALISHA FABROWICZ |
| Credential | SLP |
| Practice Address |
3325 Willowcreek Rd Portage IN 46368-5015 |
| Practice Telephone | 2197644888 |
| Practice Fax Number | 2197644805 |
| Mailing Telephone | 2197644888 |
| Mailing Fax Number | 2197644805 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 22004379A | IN | Speech, Language and Hearing Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821570953 | Alisha Puckett | Physical Therapy Assistant | 411 Alabama Ave, League City, TX 77573-2615 | 2018-09-05 |
| Street Address |
3325 WILLOWCREEK RD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-5015 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265519151 | Jacob's Ladder Pediatric Rehab Center | Physical Therapy Assistant | 3325 Willowcreek Rd, Portage, IN 46368-5015 | 2006-10-31 |
| 1013534155 | Better Life Md PC | Physical Medicine & Rehabilitation | 3325 Willowcreek Rd, Portage, IN 46368-5015 | 2020-07-05 |
| 1215194626 | Jacob's Ladder First Steps Program | Occupational Therapy Assistant | 3325 Willowcreek Rd, Portage, IN 46368-5015 | 2008-05-22 |
| 1326125923 | Gretchen Mercer | Speech-Language Pathologist | 3325 Willowcreek Rd, Portage, IN 46368-5015 | 2006-11-01 |
| 1770660516 | Cynthia Withrow | Physical Therapist | 3325 Willowcreek Rd, Portage, IN 46368-5015 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609498914 | David P Perrodin | Speech-Language Pathologist | 450 Winnebago Ave, Portage, WI 53901-1230 | 2020-05-08 |
| 1821466269 | Carissa Kostan | Speech-Language Pathologist | 130 Fowler Ln, Portage, PA 15946-7112 | 2015-09-02 |
| 1922358407 | Kimberly Lynn Ellrich | Speech-Language Pathologist | Storypoint, 3951 W Milham Ave, Portage, MI 49024 | 2012-09-12 |
| 1386947786 | Kortnee Paige Moore Warner | Speech-Language Pathologist | N328 3rd Ave, Portage, WI 53901-9314 | 2010-12-08 |
| 1871731075 | Christine L. Porter | Speech-Language Pathologist | 7507 Woodbridge Lane, Portage, MI 49024-4097 | 2009-01-26 |
| 1639328867 | Casey Jo Ambort | Speech-Language Pathologist | 626 East Slifer St, Portage, WI 53901 | 2008-09-11 |
| 1699953976 | Lana Marie Edwards | Speech-Language Pathologist | 626 East Slifer Street, Portage, WI 53901 | 2008-02-08 |
| 1417149063 | Cassandra K Ringer | Speech-Language Pathologist | 7021 Elaine Ave, Portage, IN 46368-2611 | 2007-08-16 |
| 1811019961 | Adelia M Vanmeter | Speech-Language Pathologist | 8120 Moorsbridge, Portage, MI 49024-5344 | 2007-04-06 |
| 1770601247 | Marcie A. Kovalsky | Speech-Language Pathologist | 514 Orchard Street, Portage, PA 15946 | 2007-03-26 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.