Provider Demographics
NPI:1558993675
Name:LITTON, CURTIS (SLP)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:
Last Name:LITTON
Suffix:
Gender:M
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 WOODBERRY CIR
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37663-3390
Mailing Address - Country:US
Mailing Address - Phone:423-502-2137
Mailing Address - Fax:
Practice Address - Street 1:409 WOODBERRY CIR
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37663-3390
Practice Address - Country:US
Practice Address - Phone:423-502-2137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist