Provider Demographics
NPI:1477901155
Name:SRINATH, VEENA GURUPRASAD (MS)
Entity Type:Individual
Prefix:
First Name:VEENA
Middle Name:GURUPRASAD
Last Name:SRINATH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9041 EXECUTIVE PARK DR STE 126
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4603
Mailing Address - Country:US
Mailing Address - Phone:423-534-7862
Mailing Address - Fax:865-769-0801
Practice Address - Street 1:9041 EXECUTIVE PARK DR STE 126
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4603
Practice Address - Country:US
Practice Address - Phone:423-534-7862
Practice Address - Fax:865-769-0801
Is Sole Proprietor?:No
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist