| Organization Name: | MIDDLE TENNESSEE PEDIATRIC SERVICES, PLLC |
| NPI Number: | 1730566977 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTA SHAYE BRIGHT (SPEECH-LANGUAGE PATHOLOGIST/CEO) |
| Mailing Address: | 2355 Double Log Cabin Rd Lebanon |
| State: | TN US |
| Postal Code: | 370877481 |
| Phone Number: | 6155683865 |
| Fax Number: | |
| NPI Enumeration Date: | 04/27/2015 |
| NPI Last Update Date: | 08/28/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 0000003330 |
| 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 |