Provider Demographics
NPI:1144408030
Name:PHELPS, AURORA MURRY (MA CCC-A)
Entity Type:Individual
Prefix:
First Name:AURORA
Middle Name:MURRY
Last Name:PHELPS
Suffix:
Gender:F
Credentials:MA CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 GATEWAY BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2589
Mailing Address - Country:US
Mailing Address - Phone:615-848-9265
Mailing Address - Fax:615-895-2155
Practice Address - Street 1:1370 GATEWAY BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2589
Practice Address - Country:US
Practice Address - Phone:615-848-9265
Practice Address - Fax:615-895-2155
Is Sole Proprietor?:No
Enumeration Date:2008-02-04
Last Update Date:2012-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN06/30/2009231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist