Provider Demographics
NPI:1003003112
Name:KENNEDY, ALLISON P (MA, CCC/A)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:P
Last Name:KENNEDY
Suffix:
Gender:F
Credentials:MA, CCC/A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5575 WARREN PKWY
Mailing Address - Street 2:#104
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4062
Mailing Address - Country:US
Mailing Address - Phone:469-633-9595
Mailing Address - Fax:469-633-9460
Practice Address - Street 1:5575 WARREN PKWY
Practice Address - Street 2:#104
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4062
Practice Address - Country:US
Practice Address - Phone:469-633-9595
Practice Address - Fax:469-633-9460
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51608231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist