Individual
SUSAN D HOLTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP, MA
Contact information
Practice address
187 GALLAHER RD, KINGSTON, TN 37763-4721
(865) 376-4620
(865) 376-1759
Mailing address
211 CENTER PARK DR, SUITE 3060, KNOXVILLE, TN 37922-2108
(865) 966-8545
(865) 966-3936
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3420
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4123469
BLUECROSS BLUESHIELD
TN
05
—
5440741
—
TN
Enumeration date
07/07/2006
Last updated
07/08/2007
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