MEDICARE: CLEARLY SPEAKING SPEECH PATHOLOGY SERVICES

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

Other Identifiers

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

General Provider Information

NPI Number	:	1639368830
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARLY SPEAKING SPEECH PATHOLOGY SERVICES

Provider Business Mailing Address
First Line	:	2900 TAZEWELL PIKE
Second Line	:	STE. G
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1880
Country	:	US
Telephone Number	:	865-686-0082
Fax Number	:	865-686-0174

Provider Business Practice Location Address
First Line	:	2900 TAZEWELL PIKE
Second Line	:	STE. G
City	:	KNOXVILLE
State	:	TN
Zip	:	37918-1880
Country	:	US
Telephone Number	:	865-686-0082
Fax Number	:	865-686-0174

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MRS. JEAN LOUISE BRANDON
Credential	:	MA, CCC-SLP
Telephone Number	:	865-686-0082

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	03/07/2011

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Directions to “CLEARLY SPEAKING SPEECH PATHOLOGY SERVICES ” Practice Location

Language	Start Address	Practice Location

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