Susan D Holton, SLP, MA – Speech-Language Pathologist

Key facts

NPI: 1891727780
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 3420 (TN)
Practice address: 187 Gallaher Rd
Kingston, TN 37763-4721
Phone: (865) 376-4620
Fax: (865) 376-1759
NPI assigned: Jul 7, 2006
Sex: Female
Sole proprietor: No

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.

Jane K Bryant Specialist · Kingston, TN · NPI 1558560474

NPD (past)

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 Arts

State licenses

License	State	Type	Specialty
3420	TN	MD	Mental Health Counselor

Practice roles

Organization	Specialty	Status	New patients
Jane K Bryant		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	3420	TN	Yes

Addresses

Primary practice location

187 Gallaher Rd
Kingston, TN 37763-4721

Mailing address

211 Center Park Dr
Suite 3060
Knoxville, TN 37922-2108
Phone (865) 966-8545

Other identifiers

Identifier	Type	State	Issuer
4123469	Other	TN	BLUECROSS BLUESHIELD
5440741	Medicaid	TN

Other providers in Kingston, TN

All providers in Kingston, 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 8, 2007. 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.

Verify at the official NPI Registry.