Provider Demographics
NPI:1720358625
Name:COLEMAN, BRITTANI N (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:BRITTANI
Middle Name:N
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 1:2652 COWPEN RD
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-6158
Mailing Address - Country:US
Mailing Address - Phone:606-437-1629
Mailing Address - Fax:
Practice Address - Street 1:2652 COWPEN RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-6158
Practice Address - Country:US
Practice Address - Phone:606-213-0835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist