Basic Information
Provider Information
NPI: 1801495312
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWLING
FirstName: ELLEN
MiddleName: RUTH
NamePrefix:  
NameSuffix:  
Credential: SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 306393
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372306393
CountryCode: US
TelephoneNumber: 6153731350
FaxNumber: 6152219054
Practice Location
Address1: 101 INTERNATIONAL DR STE 102
Address2:  
City: FRANKLIN
State: TN
PostalCode: 370671762
CountryCode: US
TelephoneNumber: 6152249818
FaxNumber: 6152249862
Other Information
ProviderEnumerationDate: 10/26/2020
LastUpdateDate: 10/26/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/26/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X1812TNY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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