Doctor Name: | MRS. ANN WINE |
NPI Number: | 1407003502 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 0486 |
Business Practice Address: | 1884 Thorncroft Dr Germantown, TN - 381383018 |
Business Phone Number: | 9013099911 |
Business Fax Number: | 9017550246 |
Mailing Address: | 1884 Thorncroft Dr, GERMANTOWN |
State: | TN |
Postal Code: | 381383018 |
Phone Number: | 9013099911 |
Fax Number: | 9017550246 |
NPI Enumeration Date: | 08/20/2008 |
NPI Last Update Date: | 08/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 0486 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
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 |