Basic Information
| Provider Information | |||||||||
| NPI: | 1003003112 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KENNEDY | ||||||||
| FirstName: | ALLISON | ||||||||
| MiddleName: | P. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.A., CCC/A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5575 WARREN PKWY | ||||||||
| Address2: | #104 | ||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750344062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4696339595 | ||||||||
| FaxNumber: | 4696339460 | ||||||||
| Practice Location | |||||||||
| Address1: | 5575 WARREN PKWY | ||||||||
| Address2: | #104 | ||||||||
| City: | FRISCO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750344062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4696339595 | ||||||||
| FaxNumber: | 4696339460 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/02/2007 | ||||||||
| LastUpdateDate: | 10/02/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 51608 | TX | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.