Doctor Name: | MRS. LISA G TINDELL |
NPI Number: | 1750588000 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SLP |
License Number: | 07005 |
Business Practice Address: | 814 Old Ekron Rd Brandenburg, KY - 401081149 |
Business Phone Number: | 2704222148 |
Business Fax Number: | 2704224791 |
Mailing Address: | 2192 Rosetta Corners Rd, IRVINGTON |
State: | KY |
Postal Code: | 401465849 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 07005 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
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 |