Provider Demographics
NPI:1669010104
Name:GUTHRIE, ELISABETH KATHLEEN (AUD)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:KATHLEEN
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 UNION AVENUE EXT STE 801
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38112-4416
Mailing Address - Country:US
Mailing Address - Phone:901-726-0044
Mailing Address - Fax:901-726-0858
Practice Address - Street 1:6401 POPLAR AVE STE 302
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-4823
Practice Address - Country:US
Practice Address - Phone:901-726-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1963231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist