Doctor Name: | MS. ANGELA AVRETT TIDWELL |
NPI Number: | 1497762942 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 2020 |
Business Practice Address: | 700 19th St S Audiology/speech Pathology(126) Birmingham, AL - 352331927 |
Business Phone Number: | 2059338101 |
Business Fax Number: | 2059334464 |
Mailing Address: | Po Box 72053, TUSCALOOSA |
State: | AL |
Postal Code: | 354072053 |
Phone Number: | 2055566952 |
Fax Number: | |
NPI Enumeration Date: | 08/01/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2020 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
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 |