Doctor Name: | SHANNON TYNCH |
NPI Number: | 1114177458 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 12106895 |
Business Practice Address: | 200 Buckingham Dr Winterville, NC - 285909418 |
Business Phone Number: | 2527563099 |
Business Fax Number: | 2527560667 |
Mailing Address: | 1930 White Hollow Dr, GREENVILLE |
State: | NC |
Postal Code: | 278585545 |
Phone Number: | 2522581841 |
Fax Number: | |
NPI Enumeration Date: | 09/23/2008 |
NPI Last Update Date: | 09/23/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 12106895 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
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 |