Provider Demographics
NPI:1295098184
Name:BREEDEN, BRANDALYN FONTENOT (AUD)
Entity type:Individual
Prefix:DR
First Name:BRANDALYN
Middle Name:FONTENOT
Last Name:BREEDEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:BRANDALYN
Other - Middle Name:KATE
Other - Last Name:FONTENOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:103 SUBURBAN RD STE 101D
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-5581
Mailing Address - Country:US
Mailing Address - Phone:865-769-0283
Mailing Address - Fax:
Practice Address - Street 1:103 SUBURBAN RD STE 101D
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-5581
Practice Address - Country:US
Practice Address - Phone:865-769-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-17
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1614231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist