Provider Demographics
NPI:1871003053
Name:TERREBONNE, ADRIENNE COOPER
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:COOPER
Last Name:TERREBONNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:323 LONGWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-4042
Mailing Address - Country:US
Mailing Address - Phone:318-349-2190
Mailing Address - Fax:
Practice Address - Street 1:323 LONGWOOD CT
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37043-4042
Practice Address - Country:US
Practice Address - Phone:318-349-2190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist