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General NPI Number Information
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NPI Number | 1144690991
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Entity Type | Organization
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Legal Business Name | JSD SPEECH PATHOLOGY
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Dates
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Enumeration Date | 10/05/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 6831 JODY CV
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City | BARTLETT
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State | TN
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Zip | 38135-3071
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Country | US
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Telephone | 901-409-5274
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Fax | 901-213-2114
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Provider Business Mailing Address
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Address Line | 6831 JODY CV
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City | BARTLETT
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State | TN
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Zip | 38135-3071
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Country | US
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Telephone | 901-409-5274
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Fax | 901-213-2114
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Authorized Official
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Title or Position | OWNER/SPEECH PATHOLOGIST
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Name | MS. JULIA SCOGGINS DOSS
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Credential | M.A., CCC-SLP
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Telephone | 901-409-5274
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 357
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License Number State | TN
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