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NPI Code Detail

MEDICARE: MRS. JESSICA MARIE LENDEN-HOLT M.A. CCC-SLP

MEDICARE: MRS. JESSICA MARIE LENDEN-HOLT M.A. 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
1235Z00000XSpeech-Language Pathologist103430TX
2235Z00000XSpeech-Language Pathologist3930TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114127651
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSICA MARIE LENDEN-HOLT M.A. CCC-SLP
Provider Business Mailing Address
First Line : 9041 EXECUTIVE PARK DR
Second Line : SUITE 126
City : KNOXVILLE
State : TN
Zip : 37923-4621
Country : US
Telephone Number : 423-895-1243
Fax Number : 865-769-0801
Provider Business Practice Location Address
First Line : 9041 EXECUTIVE PARK DR
Second Line : SUITE 126
City : KNOXVILLE
State : TN
Zip : 37923-4621
Country : US
Telephone Number : 423-895-1243
Fax Number : 865-769-0801
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2007
Last Update Date : 05/12/2017

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Directions to “ MRS. JESSICA MARIE LENDEN-HOLT M.A. CCC-SLP” Practice Location

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