Individual
KRISTINE C MATTHIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
156 S DOSSETT DRIVE, JOHNSON CITY, TN 37614-1702
(423) 439-4355
(423) 439-4607
Mailing address
PO BOX 70643, 156 S DOSSETT DR, JOHNSON CITY, TN 37614-1702
(423) 439-4584
(423) 439-4607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5349
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5349
ST LICENSE
TN
05
—
Q009051
—
TN
Enumeration date
10/24/2014
Last updated
04/20/2017
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