Provider Demographics
NPI:1053355511
Name:ALLEN, COLLEEN G (MSCCC-A)
Entity type:Individual
Prefix:MS
First Name:COLLEEN
Middle Name:G
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MSCCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 MORSELL DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-8046
Mailing Address - Country:US
Mailing Address - Phone:732-255-8933
Mailing Address - Fax:
Practice Address - Street 1:970 ROUTE 70
Practice Address - Street 2:AUDIOLOGY-126
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3502
Practice Address - Country:US
Practice Address - Phone:732-206-8900
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YA00035200231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist