Individual
PRENTISS STIDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.ED., CCC-SLP
Contact information
Practice address
906 N BRIARCLIFF CIR, MARYVILLE, TN 37803-6445
(865) 742-4929
Mailing address
PO BOX 6425, MARYVILLE, TN 37802-6425
(865) 742-4929
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6740
TN
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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