| Doctor Name: | MRS. TABITHA STAR HAYNIE |
| NPI Number: | 1205087186 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CFY-SLP |
| License Number: | C-4264 |
| Business Practice Address: | 2221 Dillon Rd Retirement Ranch Inc Of Clovis Clovis, NM - 881019454 |
| Business Phone Number: | 5757624495 |
| Business Fax Number: | |
| Mailing Address: | 2437 E 21st St Unit C, CLOVIS |
| State: | NM |
| Postal Code: | 881013940 |
| Phone Number: | 5753096324 |
| Fax Number: | |
| NPI Enumeration Date: | 10/09/2008 |
| NPI Last Update Date: | 10/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | C-4264 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NM |
| 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 |