Doctor Name: | MRS. TIFFANY ERINN MAYO |
NPI Number: | 1659558047 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS |
License Number: | 1117 |
Business Practice Address: | 506 Holly Ave Logan, WV - 256013306 |
Business Phone Number: | 3047922073 |
Business Fax Number: | |
Mailing Address: | 506 Holly Ave, LOGAN |
State: | WV |
Postal Code: | 256013306 |
Phone Number: | 3042392766 |
Fax Number: | |
NPI Enumeration Date: | 01/28/2008 |
NPI Last Update Date: | 04/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1117 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WV |
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 |