Organization
JOHNSON CITY SPEECH AND LANGUAGE THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DORI PENNUCCI MS, CCC/SLP (SPEECH-LANGUAGE PATHOLOGIST)
(423) 212-3853
Entity
Organization
Contact information
Practice address
2700 S ROAN ST STE 425, JOHNSON CITY, TN 37601-7587
(423) 212-3853
Mailing address
2700 S ROAN ST STE 425, JOHNSON CITY, TN 37601-7587
(423) 212-3853
(423) 805-1741
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q079383
—
TN
Enumeration date
03/23/2022
Last updated
07/02/2024
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