Provider Demographics
NPI:1386625028
Name:SEARFOSS, MARIANNE BURST (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:BURST
Last Name:SEARFOSS
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:BURST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-A
Mailing Address - Street 1:U.T. HEARING AND SPEECH CENTER
Mailing Address - Street 2:1600 PEYTON MANNING PASS
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37996-0001
Mailing Address - Country:US
Mailing Address - Phone:865-974-5451
Mailing Address - Fax:865-974-3639
Practice Address - Street 1:455 SOUTH STADIUM HALL
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37996-0001
Practice Address - Country:US
Practice Address - Phone:865-974-5453
Practice Address - Fax:865-974-1792
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001020237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3199130Medicare ID - Type UnspecifiedPART B