Provider Demographics
NPI:1659544559
Name:PENNINGTON, KATHERINE M (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:PENNINGTON
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 B GENERAL GEORGE PATTON DR.
Mailing Address - Street 2:#202
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067
Mailing Address - Country:US
Mailing Address - Phone:615-377-1623
Mailing Address - Fax:
Practice Address - Street 1:1880 B GENERAL GEORGE PATTON DR.
Practice Address - Street 2:#202
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-377-1623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000002718225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics