Provider Demographics
NPI:1134485519
Name:TROXELL, BAMBI LEANN (MCD CCC/SLP)
Entity Type:Individual
Prefix:MS
First Name:BAMBI
Middle Name:LEANN
Last Name:TROXELL
Suffix:
Gender:F
Credentials:MCD CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DERBY STREET
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404
Mailing Address - Country:US
Mailing Address - Phone:423-629-1451
Mailing Address - Fax:423-493-2914
Practice Address - Street 1:615 DERBY STREET
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404
Practice Address - Country:US
Practice Address - Phone:423-629-1451
Practice Address - Fax:423-493-2914
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4406235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist