Provider Demographics
NPI:1376027003
Name:ALLEN, ANDREA KAY (MS, CCC/SLP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:KAY
Last Name:ALLEN
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 1:600 N PEARL ST STE 1050T
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-7495
Mailing Address - Country:US
Mailing Address - Phone:888-210-9758
Mailing Address - Fax:214-271-9247
Practice Address - Street 1:600 N PEARL ST STE 1050
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-7495
Practice Address - Country:US
Practice Address - Phone:214-252-7681
Practice Address - Fax:214-271-9247
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106242235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist