Margarett Kathryn Waller, M.S., CF-SLP

Individual provider Active NPI Speech-Language Pathologist · Fountain City, TN

NPI 1275319824 · NPPES record last updated Sep 14, 2023

Key facts

NPI
1275319824
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
8504 (TN)
Practice address
2929 Tazewell Pike
Fountain City, TN 37918
Phone
(865) 328-7370
NPI assigned
Sep 7, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
8504TNMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 8504 TN Yes

Addresses

Primary practice location

2929 Tazewell Pike
Fountain City, TN 37918

Mailing address

90 Howard Dr
Shelbyville, KY 40065-8138

Other providers in Fountain City, TN

All providers in Fountain City, TN · Speech-Language Pathologist in Tennessee

Sources for this page

Verify at the official NPI Registry.