Provider Demographics
NPI:1316196355
Name:AUDIOLOGY ASSOCIATES OF TENNESSEE, INC.
Entity Type:Organization
Organization Name:AUDIOLOGY ASSOCIATES OF TENNESSEE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:COWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-A
Authorized Official - Phone:931-484-6073
Mailing Address - Street 1:44 PEAVINE PLZ STE 103
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38571-7936
Mailing Address - Country:US
Mailing Address - Phone:931-484-6073
Mailing Address - Fax:931-484-6949
Practice Address - Street 1:44 PEAVINE PLZ STE 103
Practice Address - Street 2:
Practice Address - City:CROSSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38571-7936
Practice Address - Country:US
Practice Address - Phone:931-484-6073
Practice Address - Fax:931-484-6949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001111231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3192852Medicare PIN