Provider Demographics
NPI:1235266917
Name:PHILPOT, TERRI M (MS,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:M
Last Name:PHILPOT
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 N LOCUST AVE
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-2871
Mailing Address - Country:US
Mailing Address - Phone:931-766-6374
Mailing Address - Fax:931-766-6433
Practice Address - Street 1:909 N LOCUST AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-2871
Practice Address - Country:US
Practice Address - Phone:931-766-6374
Practice Address - Fax:931-766-6433
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP530235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4055213OtherBCBS