Provider Demographics
NPI:1255929881
Name:COTTLES-TOWNSEL, TONYA NICOLE (HIS)
Entity type:Individual
Prefix:
First Name:TONYA
Middle Name:NICOLE
Last Name:COTTLES-TOWNSEL
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2479 MALL RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-2809
Mailing Address - Country:US
Mailing Address - Phone:256-766-8108
Mailing Address - Fax:
Practice Address - Street 1:2479 MALL RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-2809
Practice Address - Country:US
Practice Address - Phone:256-766-8108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2309237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist