Tami Lynn Dial, MA

Individual provider Active NPI Speech-Language Pathologist · Moscow, ID

NPI 1487985198 · NPPES record last updated Jan 22, 2010

Key facts

NPI
1487985198
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP1447 (ID)
Practice address
640 N Eisenhower St
Moscow, ID 83843-9588
Phone
(208) 882-6560
NPI assigned
Jan 19, 2010
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 Arts

State licenses

LicenseStateTypeSpecialty
SLP1447IDMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP1447 ID Yes

Addresses

Primary practice location

640 N Eisenhower St
Moscow, ID 83843-9588

Mailing address

640 N Eisehower Street
Moscow, ID 83843
Phone (208) 882-6560

Other providers in Moscow, ID

All providers in Moscow, ID · Speech-Language Pathologist in Idaho

Sources for this page

Verify at the official NPI Registry.