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Organization

LIFE SPEECH, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GRACE TRAINER (OWNER)
(865) 235-1886
Entity
Organization

Contact information

Practice address
2329 PROSSER RD, KNOXVILLE, TN 37914-3324
(912) 665-4673
Mailing address
1320 PARK GLEN RD, KNOXVILLE, TN 37919-8258
(912) 665-4673

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
Q084552
TN
Enumeration date
06/14/2023
Last updated
07/24/2023
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