Provider Demographics
NPI:1518984467
Name:CARREON-COYLE, ALICE B (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:B
Last Name:CARREON-COYLE
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 CROSS HILL RD
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-9496
Mailing Address - Country:US
Mailing Address - Phone:610-746-9117
Mailing Address - Fax:
Practice Address - Street 1:3110 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3630
Practice Address - Country:US
Practice Address - Phone:610-776-4358
Practice Address - Fax:610-776-4407
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT000823L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist