Provider Demographics
NPI:1609968171
Name:TURNER, KANDACE L (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KANDACE
Middle Name:L
Last Name:TURNER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5338 N BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-3238
Mailing Address - Country:US
Mailing Address - Phone:865-219-9641
Mailing Address - Fax:865-219-9642
Practice Address - Street 1:5338 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37918-3238
Practice Address - Country:US
Practice Address - Phone:865-219-9641
Practice Address - Fax:865-219-9642
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001894235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist