Tyann Nettleton, M.S SLP-CCC

Individual provider Active NPI Speech-Language Pathologist · Houston, MO

NPI 1487101291 · NPPES record last updated Sep 9, 2016

Key facts

NPI
1487101291
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
2016023444 (MO)
Practice address
423 W Pine St
Houston, MO 65483-1147
Phone
(417) 967-3196
Fax
(417) 967-2923
NPI assigned
Sep 9, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2016023444MOMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2016023444 MO Yes

Addresses

Primary practice location

423 W Pine St
Houston, MO 65483-1147

Mailing address

423 W Pine St
Houston, MO 65483-1147
Phone (417) 967-3196

Other providers in Houston, MO

All providers in Houston, MO · Speech-Language Pathologist in Missouri

Sources for this page

Verify at the official NPI Registry.