Provider Demographics
NPI:1881973915
Name:BRANSON, STEVEN J (PHD, CCC-SLP)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:BRANSON
Suffix:
Gender:M
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6004 BURNETT CIR
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-5079
Mailing Address - Country:US
Mailing Address - Phone:615-261-8150
Mailing Address - Fax:
Practice Address - Street 1:6004 BURNETT CIR
Practice Address - Street 2:
Practice Address - City:THOMPSONS STATION
Practice Address - State:TN
Practice Address - Zip Code:37179-5079
Practice Address - Country:US
Practice Address - Phone:615-261-8150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-07
Last Update Date:2011-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNSP 0000003344235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist