Provider Demographics
NPI:1447227079
Name:COTTRELL, CHARLENE VILA (MS,CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:CHARLENE
Middle Name:VILA
Last Name:COTTRELL
Suffix:
Gender:F
Credentials:MS,CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9912 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34654-3419
Mailing Address - Country:US
Mailing Address - Phone:727-869-4200
Mailing Address - Fax:727-869-4148
Practice Address - Street 1:9912 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34654-3419
Practice Address - Country:US
Practice Address - Phone:727-869-4200
Practice Address - Fax:727-869-4148
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY687231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist