Individual
REGINA M MCDONOUGH-PYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SPEECH PATHOLOGIST
Contact information
Practice address
2301 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2959
(423) 566-2250
(423) 566-5896
Mailing address
2301 JACKSBORO PIKE, LA FOLLETTE, TN 37766-2959
(423) 566-2250
(423) 566-5896
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP1650
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SP1650
SPEECH LICENSE #
TN
Enumeration date
08/25/2006
Last updated
07/08/2007
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