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NPI 1295480374

NPI 1295480374 : JENNA DANELL ALLEN M.S., CCC-SLP : COLUMBIA, LA

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General NPI Number Information
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    NPI Number           |    1295480374
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    Entity Type          |    Individual 
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    Provider Name        |    JENNA DANELL ALLEN M.S., CCC-SLP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    02/16/2022
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    Last Update Date     |    02/16/2022
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Provider Practice Location Address
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    Address Line         |    7726 HIGHWAY 165 
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    City                 |    COLUMBIA
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    State                |    LA
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    Zip                  |    71418-3322
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    Country              |    US
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    Telephone            |    318-649-9800
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    12 QUAIL RIDGE DR 
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    City                 |    MONROE
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    State                |    LA
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    Zip                  |    71203-9629
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    235Z00000X
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    Taxonomy Name        |    Speech-Language Pathologist
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    License Number       |    8318
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    License Number State |    LA
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