Provider Demographics
NPI:1114109022
Name:THERAPEUTICONCEPTS
Entity Type:Organization
Organization Name:THERAPEUTICONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KATY
Authorized Official - Middle Name:ACUFF
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:SLP
Authorized Official - Phone:865-475-1858
Mailing Address - Street 1:1515 MEADOW SPRING DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37760-2047
Mailing Address - Country:US
Mailing Address - Phone:865-475-1858
Mailing Address - Fax:865-472-1859
Practice Address - Street 1:1515 MEADOW SPRING DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-2047
Practice Address - Country:US
Practice Address - Phone:865-475-1858
Practice Address - Fax:865-472-1859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3465235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty