Individual
MADISON MATHENIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2030 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804-5285
(865) 982-3400
(865) 238-2034
Mailing address
PO BOX 5209, MARYVILLE, TN 37802-5209
(865) 982-3400
(865) 238-2034
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
60678215
WA
235Z00000X
Speech-Language Pathologist
Primary
6794
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q051047
—
TN
Enumeration date
02/13/2017
Last updated
08/16/2019
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