Cathleen C Brady, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Chattanogoa, TN

NPI 1790079192 · NPPES record last updated Jun 2, 2011

Key facts

NPI
1790079192
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SP0000001604 (TN)
Practice address
4204 Benton Dr
Chattanogoa, TN 37406-1256
Phone
(423) 468-4060
Fax
(423) 468-4069
NPI assigned
Jun 2, 2011
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

State licenses

LicenseStateTypeSpecialty
SP0000001604TNMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SP0000001604 TN Yes

Addresses

Primary practice location

4204 Benton Dr
Chattanogoa, TN 37406-1256

Mailing address

4204 Benton Dr
Chattanogoa, TN 37406
Phone (423) 468-4060

Sources for this page

Verify at the official NPI Registry.