Provider Demographics
NPI:1285673442
Name:HUMPHREY, ELIZABETH LYNN (AUD, CCC-A)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LYNN
Last Name:HUMPHREY
Suffix:
Gender:F
Credentials:AUD, 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: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:865-974-5453
Mailing Address - Fax:865-974-1792
Practice Address - Street 1:U.T. HEARING AND SPEECH CENTER
Practice Address - Street 2:1600 PEYTON MANNING PASS
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-5453
Practice Address - Fax:865-974-1792
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2010-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001391231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist