Provider Demographics
NPI:1174416465
Name:OLIVE BRANCH SPEECH THERAPY
Entity type:Organization
Organization Name:OLIVE BRANCH SPEECH THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:SYDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRIDENSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-924-0791
Mailing Address - Street 1:408 MOSS CREEK CT
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37221-2828
Mailing Address - Country:US
Mailing Address - Phone:615-669-4408
Mailing Address - Fax:
Practice Address - Street 1:408 MOSS CREEK CT
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37221-2828
Practice Address - Country:US
Practice Address - Phone:615-669-4408
Practice Address - Fax:865-424-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-03
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language AssistantGroup - Multi-Specialty