Jennie Reagan, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Wartburg, TN
NPI 1194013755 · NPPES record last updated Jul 18, 2011
Key facts
- NPI
- 1194013755
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 2665 (TN)
- Practice address
- 136 Flat Fork Rd
Wartburg, TN 37887-3200 - Phone
- (423) 622-1551
- Fax
- (423) 622-1556
- NPI assigned
- Jul 18, 2011
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2665 | TN | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Morgan County Schools | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2665 | TN | Yes |
Addresses
Primary practice location
136 Flat Fork Rd
Wartburg, TN 37887-3200
Mailing address
PO Box 8114
Chattanooga, TN 37414-0114
Phone (423) 622-1551
Other providers in Wartburg, TN
- Timothy Sutton Ochs
- Peak Performance Rehabilitation, Inc
- Andrea Rose Pease
- Pink Coyote, Inc.
- Jonna Leeann Pittman
- Meagan Elizabeth Redmon
- Kimberly Rinks
- Kayla Renea Ruppe
- Autum Marie Salsbury
- Jonathan Schmidt
All providers in Wartburg, TN · Speech-Language Pathologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.