Provider Demographics
NPI:1164995072
Name:KANNA, RHODA
Entity Type:Individual
Prefix:
First Name:RHODA
Middle Name:
Last Name:KANNA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CARTWHEEL RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-2054
Mailing Address - Country:US
Mailing Address - Phone:423-639-4194
Mailing Address - Fax:
Practice Address - Street 1:910 W SUMMER ST
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-3016
Practice Address - Country:US
Practice Address - Phone:423-639-4194
Practice Address - Fax:423-639-1615
Is Sole Proprietor?:No
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5835235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist