Tanya W Bryant, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Hattiesburg, MS
NPI 1609902840 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1609902840
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- S2491 (MS)
- Practice address
- 100 W Front St
Hattiesburg, MS 39401-3460 - Phone
- (601) 408-1003
- Fax
- (601) 582-4258
- NPI assigned
- Feb 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S2491 | MS | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | S2491 | MS | Yes |
Addresses
Primary practice location
100 W Front St
Hattiesburg, MS 39401-3460
Mailing address
PO Box 49
Hattiesburg, MS 39403-0049
Phone (601) 408-1003
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00124640 | Medicaid | MS |
Other providers in Hattiesburg, MS
- Sarah Elizabeth Brumfield
- Shermanda M Brumfield
- Bryant Therapy Services, LLC
- Jeff A Bryant
- Patrick Bryant
- Mary Buckley
- Stephen E Buckley
- Scott Buckner
- Sidne Buelow
- Margaret Bullerjahn
All providers in Hattiesburg, MS · Speech-Language Pathologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.