Provider Demographics
NPI:1295356426
Name:COONCE, ALLISON ROSE (MS-SLP-CCC)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:ROSE
Last Name:COONCE
Suffix:
Gender:F
Credentials:MS-SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:623 CHELTENHAM AVE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-8659
Mailing Address - Country:US
Mailing Address - Phone:931-218-8665
Mailing Address - Fax:
Practice Address - Street 1:623 CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-8659
Practice Address - Country:US
Practice Address - Phone:931-218-8665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-28
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6866235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6866Medicaid