Kathryn Ballance, SLP

Individual provider Active NPI Speech-Language Pathologist · La Follette, TN

NPI 1497061808 · NPPES record last updated Dec 21, 2021

Key facts

NPI
1497061808
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
7766 (TN)
Practice address
136 Davis LN
La Follette, TN 37766-3118
Phone
(423) 562-0760
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
7766TNMDSpeech-Language Pathologist
104495TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
S. Potts and Professionals, Inc. Speech-Language Pathologist Past
since Oct 19, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 104495 TX
Speech-Language Pathologist 235Z00000X 7766 TN Yes

Addresses

Primary practice location

136 Davis LN
La Follette, TN 37766-3118

Mailing address

136 Davis LN
La Follette, TN 37766-3118
Phone (423) 562-0760

Other providers in La Follette, TN

All providers in La Follette, TN · Speech-Language Pathologist in Tennessee

Sources for this page

Verify at the official NPI Registry.