| Organization Name: | EAST TENNESSEE STATE UNIVERSITY |
| NPI Number: | 1962432609 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID D. COLLINS (CFO, VP FINANCE & ADMINISTRATION) |
| Mailing Address: | 807 University Pkwy Etsu Campus Lamb Hall Room 361 Johnson City |
| State: | TN US |
| Postal Code: | 376141702 |
| Phone Number: | 4234394355 |
| Fax Number: | 4234394607 |
| NPI Enumeration Date: | 07/04/2006 |
| NPI Last Update Date: | 12/08/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| 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 |