Provider Demographics
NPI:1821276619
Name:SPERRY, MARIANNE PATRICIA (MACCC/SLP)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:PATRICIA
Last Name:SPERRY
Suffix:
Gender:F
Credentials:MACCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5819 OLD HARDING RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-3619
Mailing Address - Country:US
Mailing Address - Phone:615-356-6339
Mailing Address - Fax:
Practice Address - Street 1:5819 OLD HARDING RD
Practice Address - Street 2:SUITE 205
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-3619
Practice Address - Country:US
Practice Address - Phone:615-356-6339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001913235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist