Individual
TERESA LYNN BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., 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 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-4584
(423) 439-4607
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1220
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1510971
—
TN
01
—
SP1220
TENNESSEE LICENSE
TN
Enumeration date
01/05/2007
Last updated
01/16/2024
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