Provider Demographics
NPI:1295949253
Name:KIRBY, ANTHONY BRENT (MS, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:BRENT
Last Name:KIRBY
Suffix:
Gender:M
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9820 ELK HORN LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3564
Mailing Address - Country:US
Mailing Address - Phone:865-805-8778
Mailing Address - Fax:865-693-9991
Practice Address - Street 1:9820 ELK HORN LN
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3564
Practice Address - Country:US
Practice Address - Phone:865-805-8778
Practice Address - Fax:865-693-9991
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP0000002701235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist