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General NPI Number Information
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NPI Number | 1619965498
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Entity Type | Individual
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Provider Name | KATHLEEN E. MAHN M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 10/06/2005
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 600 N HOLTZCLAW AVE STE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1242
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Country | US
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Telephone | 423-622-6900
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Fax | 423-622-4834
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Provider Business Mailing Address
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Address Line | 600 N HOLTZCLAW AVE SUITE 200
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City | CHATTANOOGA
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State | TN
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Zip | 37404-1240
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Country | US
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Telephone | 423-622-6900
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Fax | 423-622-4834
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | SP00687
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License Number State | TN
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