Provider Demographics
NPI:1033983523
Name:OSLUND, AMANDA
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:
Last Name:OSLUND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MANDIE
Other - Middle Name:
Other - Last Name:OSLUND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:5924 W PINE LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1037
Mailing Address - Country:US
Mailing Address - Phone:310-533-7640
Mailing Address - Fax:
Practice Address - Street 1:1250 TENNOVA MEDICAL WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-3120
Practice Address - Country:US
Practice Address - Phone:310-533-7640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-14
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5886235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist