Individual
MRS. ELIZABETH STAFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
912 S GAY ST, KNOXVILLE, TN 37902-1814
(865) 594-1540
(865) 594-1531
Mailing address
912 S GAY ST, KNOXVILLE, TN 37902-1814
(865) 539-7888
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000289027
PROFESSIONAL SCHOOL SERVICE PERSONNEL LICENSE
TN
Enumeration date
03/04/2014
Last updated
03/05/2014
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