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General NPI Number Information
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NPI Number | 1659033371
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Entity Type | Organization
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Legal Business Name | SPEAKEASY THERAPY LLC
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Dates
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Enumeration Date | 10/11/2021
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Last Update Date | 10/11/2021
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Provider Practice Location Address
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Address Line | 3179 CREEKBEND LN
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City | KNOXVILLE
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State | TN
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Zip | 37931-3204
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Country | US
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Telephone | 276-970-4860
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Fax |
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Provider Business Mailing Address
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Address Line | 3179 CREEKBEND LN
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City | KNOXVILLE
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State | TN
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Zip | 37931-3204
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Country | US
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Telephone | 276-970-4860
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAYLA DANIELLE DOANE
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Credential | M.S. CCC-SLP
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Telephone | 276-970-4860
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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 |
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License Number State |
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