Doctor Name: | TIFFANY R POWELL |
NPI Number: | 1538472790 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 100374 |
Business Practice Address: | 1200 Highway 100 Suite 9 Port Isabel, TX - 785782462 |
Business Phone Number: | 9566078329 |
Business Fax Number: | |
Mailing Address: | 225 Mesquite Dr, LAGUNA VISTA |
State: | TX |
Postal Code: | 785782708 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/16/2010 |
NPI Last Update Date: | 07/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 100374 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
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 |