Provider Demographics
NPI:1598568180
Name:SCENIC CITY SPEECH LLC
Entity type:Organization
Organization Name:SCENIC CITY SPEECH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:VITRANO
Authorized Official - Suffix:
Authorized Official - Credentials:MA-CCC
Authorized Official - Phone:423-903-2498
Mailing Address - Street 1:8282 DOUBLE EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7175
Mailing Address - Country:US
Mailing Address - Phone:423-903-2498
Mailing Address - Fax:
Practice Address - Street 1:6011 CHESTERTON WAY STE 201
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-1519
Practice Address - Country:US
Practice Address - Phone:423-903-2498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty