Provider Demographics
NPI:1831335249
Name:TREMBATH, DENA M (SLP)
Entity type:Individual
Prefix:
First Name:DENA
Middle Name:M
Last Name:TREMBATH
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40065-8138
Mailing Address - Country:US
Mailing Address - Phone:502-633-1007
Mailing Address - Fax:502-805-1511
Practice Address - Street 1:855 W COLLEGE ST STE F
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2762
Practice Address - Country:US
Practice Address - Phone:615-614-8833
Practice Address - Fax:502-805-1511
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN333135235Z00000X
TN0000007065235Z00000X
NY018555-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN0000007065Medicaid