Provider Demographics
NPI:1093106403
Name:NEAS, MATTHEW RYAN (MS CCC-SLP)
Entity Type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:RYAN
Last Name:NEAS
Suffix:
Gender:M
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9041 EXECUTIVE PARK DR STE 126
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4603
Mailing Address - Country:US
Mailing Address - Phone:423-329-1241
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:9041 EXECUTIVE PARK DR STE 126
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4603
Practice Address - Country:US
Practice Address - Phone:865-693-5622
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2015-02-07
Last Update Date:2015-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5372235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist