| Doctor Name: | TINA CLUMPNER |
| NPI Number: | 1639312010 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.S., CCC-SLP |
| License Number: | SLP S 270 |
| Business Practice Address: | 104 Center Ave Suite 200 Kodiak, AK - 996156393 |
| Business Phone Number: | 9075120979 |
| Business Fax Number: | 9075123023 |
| Mailing Address: | Po Box 568, KODIAK |
| State: | AK |
| Postal Code: | 996150568 |
| Phone Number: | 9075120979 |
| Fax Number: | 9075123023 |
| NPI Enumeration Date: | 04/14/2009 |
| NPI Last Update Date: | 08/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SLP S 270 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AK |
| 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 |