Individual
JENNY LOTHAMER WITHEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
6205 WINTERGREEN RD, MORRISTOWN, TN 37814
(864) 426-1619
Mailing address
6205 WINTERGREEN RD, MORRISTOWN, TN 37814-1312
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6157
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6157
TENNESSEE BOARD OF COMMUNICATION DISORDERS
TN
Enumeration date
08/01/2017
Last updated
08/01/2017
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