Provider Demographics
NPI:1295525269
Name:HENEGAR, ADRIENNE (CFY-SLP)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:HENEGAR
Suffix:
Gender:F
Credentials:CFY-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1825 W LAKEVIEW DR APT H61
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4315
Mailing Address - Country:US
Mailing Address - Phone:423-747-4739
Mailing Address - Fax:
Practice Address - Street 1:300 NETHERLAND LN
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-7481
Practice Address - Country:US
Practice Address - Phone:423-849-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist