Provider Demographics
NPI:1093279218
Name:MURRAY, ELAINE COLEMAN (SLP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:COLEMAN
Last Name:MURRAY
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-7120
Mailing Address - Country:US
Mailing Address - Phone:423-232-9273
Mailing Address - Fax:
Practice Address - Street 1:5 BINGHAM CT
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-7120
Practice Address - Country:US
Practice Address - Phone:423-232-9273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1384235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist