Provider Demographics
NPI:1245990159
Name:BOONE, ALEENA WOODLYN (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:ALEENA
Middle Name:WOODLYN
Last Name:BOONE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 CALVARY LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37683-4306
Mailing Address - Country:US
Mailing Address - Phone:423-218-9729
Mailing Address - Fax:
Practice Address - Street 1:144 CALVARY LN
Practice Address - Street 2:
Practice Address - City:MOUNTAIN CITY
Practice Address - State:TN
Practice Address - Zip Code:37683-4306
Practice Address - Country:US
Practice Address - Phone:423-218-9729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6229235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist