Stacey Branson, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Tullahoma, TN
NPI 1902223316 · NPPES record last updated Mar 24, 2014
Key facts
- NPI
- 1902223316
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- SP4757 (TN)
- Practice address
- 2110 N. Jackson Street
Tullahoma, TN 37388 - Phone
- (931) 455-5189
- Fax
- (931) 393-2455
- NPI assigned
- Mar 24, 2014
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| SP4757 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Top Rehab Services, Inc. | Speech-Language Pathologist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | SP4757 | TN | Yes |
Addresses
Primary practice location
2110 N. Jackson Street
Tullahoma, TN 37388
Mailing address
2110 N. Jackson Street
Tullahoma, TN 37388
Phone (931) 455-5189
Other providers in Tullahoma, TN
- Leanna Mashae Bonner
- Jennifer O'Neal Bowles
- Magen Michelle Boyd
- Aubrey Brackett
- William B Bradford
- Tina Breshears
- Alexander Matthew Bresnee
- Jessica Patterson Bridges
- Shanna Bobo Brooks
- Charis N Brown
All providers in Tullahoma, 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 Mar 24, 2014. 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.