Doctor Name: | MRS. TONYA SHONDELL RUSH |
NPI Number: | 1518030303 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS CF SLP |
License Number: | C4003 |
Business Practice Address: | 103 North Church Street Elida Municipal School Elida, NM - 88116 |
Business Phone Number: | 5052746211 |
Business Fax Number: | 5052746213 |
Mailing Address: | 5545 State Highway 209, MCALISTER |
State: | NM |
Postal Code: | 88427 |
Phone Number: | 5054586611 |
Fax Number: | 5054586611 |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | C4003 |
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 |