Doctor Name: | LEIGH TATUM |
NPI Number: | 1699157842 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, CCC-SLP |
License Number: | 102704 |
Business Practice Address: | 76 Osprey Village Dr Amelia Island, FL - 320344962 |
Business Phone Number: | 9042773337 |
Business Fax Number: | |
Mailing Address: | 123 Cedar St, NEPTUNE BEACH |
State: | FL |
Postal Code: | 322666017 |
Phone Number: | 5125877468 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2015 |
NPI Last Update Date: | 06/24/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 102704 |
Healthcare Provider Taxonomy: (Secondary) | N |
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 |