Provider Demographics
NPI:1326378787
Name:COLEMAN, AMY LYNN (MS-CCC/SLP)
Entity Type:Individual
Prefix:MISS
First Name:AMY
Middle Name:LYNN
Last Name:COLEMAN
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 1:1700 APPOMATTOX RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2210
Mailing Address - Country:US
Mailing Address - Phone:606-748-8800
Mailing Address - Fax:
Practice Address - Street 1:1700 APPOMATTOX RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-2210
Practice Address - Country:US
Practice Address - Phone:606-748-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-07
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3288235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist