Healthcare Provider Details

I. General information

NPI: 1649803156
Provider Name (Legal Business Name): CHANEL A COYNE SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11242 STRANG LINE RD
LENEXA KS
66215-4039
US

IV. Provider business mailing address

11242 STRANG LINE RD
LENEXA KS
66215-4039
US

V. Phone/Fax

Practice location:
  • Phone: 913-980-4277
  • Fax:
Mailing address:
  • Phone: 706-507-4433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPCE003063
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: