Individual
MRS. JENNIFER L QUILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
156 S. DOSSETT DRIVE, LAMB HALL, ROOM 363, JOHNSON CITY, TN 37614
(423) 439-4355
(423) 439-4607
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 433-6039
(423) 433-6060
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2202006935
VA
235Z00000X
Speech-Language Pathologist
Primary
3094
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q048291
—
TN
Enumeration date
10/03/2016
Last updated
01/24/2024
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