Provider Demographics
NPI:1962077180
Name:FLOWERS, MARY K (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:K
Last Name:FLOWERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4241 BIFFLE LN
Mailing Address - Street 2:
Mailing Address - City:HAMPSHIRE
Mailing Address - State:TN
Mailing Address - Zip Code:38461-4569
Mailing Address - Country:US
Mailing Address - Phone:931-994-8162
Mailing Address - Fax:
Practice Address - Street 1:1511 NASHVILLE HWY STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-2070
Practice Address - Country:US
Practice Address - Phone:931-490-7770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-20
Last Update Date:2021-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist