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General NPI Number Information
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NPI Number | 1700015336
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Entity Type | Individual
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Provider Name | NOLA RADFORD PH.D., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 07/13/2021
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Provider Practice Location Address
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Address Line | HEARING AND SPEECH CTR 1600 PEYTON MANNING PASS
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City | KNOXVILLE
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State | TN
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Zip | 37996-0001
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Country | US
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Telephone | 865-974-2672
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 32692
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City | KNOXVILLE
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State | TN
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Zip | 37930-2692
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Country | US
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Telephone | 865-985-1656
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Fax |
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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 | 6005
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 49540
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License Number State | MS
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