MEDICARE: MONICA LEE DURRETT MS,CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP 0000002858	TN
2	235Z00000X	Speech-Language Pathologist	2858	TN

General Provider Information

NPI Number	:	1033312731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA LEE DURRETT MS,CCC-SLP

Provider Business Mailing Address
First Line	:	PO BOX 306393
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37230-6393
Country	:	US
Telephone Number	:	615-373-1350
Fax Number	:	615-221-9054

Provider Business Practice Location Address
First Line	:	2004 HAYES ST STE 545
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-2655
Country	:	US
Telephone Number	:	615-284-7555
Fax Number	:	615-284-7075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	12/10/2020

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