| Doctor Name: | MRS. TAWNY CRYSTAL SMALL-BURNAM |
| NPI Number: | 1376747428 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | SLP |
| License Number: | SLP005983 |
| Business Practice Address: | 6886 Main St Ste 1b2 Box 4 Lithonia, GA - 300584508 |
| Business Phone Number: | 7703674241 |
| Business Fax Number: | 7704829401 |
| Mailing Address: | 6886 Main St Ste 1b2, Box 4 LITHONIA |
| State: | GA |
| Postal Code: | 300584508 |
| Phone Number: | 7703674241 |
| Fax Number: | |
| NPI Enumeration Date: | 06/13/2007 |
| NPI Last Update Date: | 11/30/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP005983 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| 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 |