Provider Demographics
NPI:1447214705
Name:FEENEY, TAWN REYNOLDS (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TAWN
Middle Name:REYNOLDS
Last Name:FEENEY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:TAWN
Other - Middle Name:
Other - Last Name:REYNOLDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6198 MARROWBACK RD
Mailing Address - Street 2:
Mailing Address - City:CONESUS
Mailing Address - State:NY
Mailing Address - Zip Code:14435-9541
Mailing Address - Country:US
Mailing Address - Phone:585-271-0680
Mailing Address - Fax:585-442-4114
Practice Address - Street 1:1000 ELMWOOD AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3042
Practice Address - Country:US
Practice Address - Phone:585-271-0680
Practice Address - Fax:585-442-4114
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001330-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist