Doctor Name: | TAMMY A POWELL |
NPI Number: | 1104019298 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | S2957 |
Business Practice Address: | 13 Northtown Dr Suite 110 Jackson, MS - 392113047 |
Business Phone Number: | 6012069195 |
Business Fax Number: | 6019578391 |
Mailing Address: | 13 Northtown Dr, Suite 110 JACKSON |
State: | MS |
Postal Code: | 392113047 |
Phone Number: | 6012069195 |
Fax Number: | 6019578391 |
NPI Enumeration Date: | 08/22/2007 |
NPI Last Update Date: | 08/22/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | S2957 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |