Provider Demographics
NPI:1144690991
Name:JSD SPEECH PATHOLOGY
Entity type:Organization
Organization Name:JSD SPEECH PATHOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:SCOGGINS
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:901-409-5274
Mailing Address - Street 1:6831 JODY CV
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-3071
Mailing Address - Country:US
Mailing Address - Phone:901-409-5274
Mailing Address - Fax:901-213-2114
Practice Address - Street 1:6831 JODY CV
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38135-3071
Practice Address - Country:US
Practice Address - Phone:901-409-5274
Practice Address - Fax:901-213-2114
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN357251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health