Provider Demographics
NPI:1013032580
Name:TOON, ANDRIA M (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:ANDRIA
Middle Name:M
Last Name:TOON
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:PO BOX 7833
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40257-0833
Mailing Address - Country:US
Mailing Address - Phone:502-494-3379
Mailing Address - Fax:
Practice Address - Street 1:506 BEDFORDSHIRE RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5509
Practice Address - Country:US
Practice Address - Phone:502-494-3379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2624235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist