Provider Demographics
NPI:1861188518
Name:SOUTHERN EXPRESSIONS THERAPY COMPANY PLLC
Entity type:Organization
Organization Name:SOUTHERN EXPRESSIONS THERAPY COMPANY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MSCCC-SLP
Authorized Official - Phone:615-364-0274
Mailing Address - Street 1:214 APLIN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:COTTONTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37048-9244
Mailing Address - Country:US
Mailing Address - Phone:615-364-0274
Mailing Address - Fax:
Practice Address - Street 1:214 APLIN BRANCH RD
Practice Address - Street 2:
Practice Address - City:COTTONTOWN
Practice Address - State:TN
Practice Address - Zip Code:37048-9244
Practice Address - Country:US
Practice Address - Phone:615-364-0274
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-14
Last Update Date:2023-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty