Provider Demographics
NPI:1811773567
Name:ALLEN, ABBIE (MS-SLP)
Entity type:Individual
Prefix:
First Name:ABBIE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MS-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 E CUMBERLAND AVE UNIT 302
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33602-4228
Mailing Address - Country:US
Mailing Address - Phone:904-614-1869
Mailing Address - Fax:
Practice Address - Street 1:18115 N US HIGHWAY 41 STE 800
Practice Address - Street 2:
Practice Address - City:LUTZ
Practice Address - State:FL
Practice Address - Zip Code:33549-6475
Practice Address - Country:US
Practice Address - Phone:813-848-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ11595235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist