Provider Demographics
NPI:1942506985
Name:JENNINGS, MEREDITH ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:MEREDITH
Middle Name:ANN
Last Name:JENNINGS
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 1:4738 CENTERLINE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1401
Mailing Address - Country:US
Mailing Address - Phone:865-546-0801
Mailing Address - Fax:
Practice Address - Street 1:4738 CENTERLINE DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1401
Practice Address - Country:US
Practice Address - Phone:865-546-0801
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4181235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist