Individual
TINA LANETTE VINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MACCCSLP
Contact information
Practice address
175 HOSPITAL DR, MC KENZIE, TN 38201-1636
(731) 352-3908
(731) 352-4579
Mailing address
327 HEAD ST, PARIS, TN 38242-4140
(731) 642-7439
(731) 642-9447
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP0000001960
TN
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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