Provider Demographics
NPI:1326310582
Name:CBM SPEECH PATHOLOGY SERVICES, LLC
Entity Type:Organization
Organization Name:CBM SPEECH PATHOLOGY SERVICES, LLC
Other - Org Name:MOSER SPEECH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CLAIRE
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOSER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:865-579-2293
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-1223
Mailing Address - Country:US
Mailing Address - Phone:865-579-2293
Mailing Address - Fax:865-579-2295
Practice Address - Street 1:10721 CHAPMAN HWY
Practice Address - Street 2:SUITE 22
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-4765
Practice Address - Country:US
Practice Address - Phone:865-579-2293
Practice Address - Fax:865-579-2295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-03
Last Update Date:2012-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000004199235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty