Provider Demographics
NPI:1316231871
Name:ALLEN-NUNES, NATALIE E (SLP)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:E
Last Name:ALLEN-NUNES
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 LAINSTER DR SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-2776
Mailing Address - Country:US
Mailing Address - Phone:678-234-6647
Mailing Address - Fax:
Practice Address - Street 1:1209 LAINSTER DR SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-2776
Practice Address - Country:US
Practice Address - Phone:678-234-6647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-01
Last Update Date:2011-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004517235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist