Healthcare Provider Details

I. General information

NPI: 1366677312
Provider Name (Legal Business Name): KRISTI M. ZOLLINGER M.S. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2009
Last Update Date: 05/28/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9040 EXECUTIVE PARK DR SUITE 105
KNOXVILLE TN
37923-4640
US

IV. Provider business mailing address

9040 EXECUTIVE PARK DR SUITE 105
KNOXVILLE TN
37923-4640
US

V. Phone/Fax

Practice location:
  • Phone: 865-693-5622
  • Fax: 865-769-0801
Mailing address:
  • Phone: 423-775-6505
  • Fax: 865-769-0801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number0000002967
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: