Provider Demographics
NPI:1255312153
Name:BUEHLER, MARY VELVET (MA, CCC-SLP/A)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:VELVET
Last Name:BUEHLER
Suffix:
Gender:F
Credentials:MA, CCC-SLP/A
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:VELVET
Other - Last Name:NORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP/A
Mailing Address - Street 1:U.T. HEARING AND SPEECH CENTER
Mailing Address - Street 2:1600 PEYTON MANNING PASS
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-5451
Mailing Address - Fax:865-974-1792
Practice Address - Street 1:455 SOUTH STADIUM HALL
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-1788
Practice Address - Fax:865-974-1539
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001938231H00000X
TN0000000817235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ002999Medicaid