Provider Demographics
NPI:1699557421
Name:PRITCHETT, LYDIA ELIZABETH (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:ELIZABETH
Last Name:PRITCHETT
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 E BLOUNT AVE APT 151
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1663
Mailing Address - Country:US
Mailing Address - Phone:731-343-3761
Mailing Address - Fax:
Practice Address - Street 1:9649 WESTLAND DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-5113
Practice Address - Country:US
Practice Address - Phone:865-223-6422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8564235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist