Doctor Name: | MR. RAGHUNATH VEDALA |
NPI Number: | 1316177421 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MSCCCSLP |
License Number: | 2012 |
Business Practice Address: | 2075 N Germantown Pkwy Suite 108 Cordova, TN - 380161729 |
Business Phone Number: | 9012466809 |
Business Fax Number: | |
Mailing Address: | 8910 Roby Cv, CORDOVA |
State: | TN |
Postal Code: | 380164092 |
Phone Number: | 9012466809 |
Fax Number: | 9012029088 |
NPI Enumeration Date: | 07/23/2009 |
NPI Last Update Date: | 02/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |