Individual
BREANNA RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
2030 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804-5285
(865) 982-3400
Mailing address
2279 ATKINSON RD, BILOXI, MS 39531-2209
(228) 388-1805
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
4067
AL
235Z00000X
Speech-Language Pathologist
Primary
6742
TN
235Z00000X
Speech-Language Pathologist
S3878
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q071423
—
TN
Enumeration date
08/12/2016
Last updated
03/01/2022
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