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General NPI Number Information
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NPI Number | 1194158204
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Entity Type | Organization
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Legal Business Name | ELIZABETH JENKINS
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Dates
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Enumeration Date | 08/12/2013
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 127 S KENTUCKY ST
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City | KINGSTON
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State | TN
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Zip | 37763-2746
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Country | US
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Telephone | 865-705-8688
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Fax | 865-285-9411
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Provider Business Mailing Address
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Address Line | 404 COFFEE LN
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City | LOUDON
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State | TN
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Zip | 37774-6612
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Country | US
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Telephone | 865-661-5380
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Fax | 865-285-9411
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | ELIZABETH JENKINS
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Credential |
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Telephone | 865-661-5380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 0
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License Number State | TN
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