Provider Demographics
NPI:1992162895
Name:TRILLIUM SPEECH, LANGUAGE, & VOICE SERVICES, LLC
Entity type:Organization
Organization Name:TRILLIUM SPEECH, LANGUAGE, & VOICE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:
Authorized Official - Last Name:TURCZYN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:865-214-7384
Mailing Address - Street 1:PO BOX 27716
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37927-7716
Mailing Address - Country:US
Mailing Address - Phone:865-214-7384
Mailing Address - Fax:
Practice Address - Street 1:1400 N 6TH AVE STE D4
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-6043
Practice Address - Country:US
Practice Address - Phone:865-214-7384
Practice Address - Fax:844-790-8092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-22
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ019306Medicaid