Individual
MRS. KRISTY STRONG EISENZOPF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
156 S. DOSSETT DRIVE, LAMB HALL, ROOM 363, JOHNSON CITY, TN 37614-1702
(423) 439-4355
(423) 439-4607
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-4584
(423) 439-4607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
SA 10286
FL
235Z00000X
Speech-Language Pathologist
Primary
SP5247
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5247
TN LICENSE TO PRACTICE
TN
05
—
Q006294
—
TN
Enumeration date
05/05/2010
Last updated
02/26/2024
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