Clark, Tanya Williams

Clark, Tanya Williams is an sole proprietor health care provider with primary practice located at 100 South West St. , Bainbridge GA 39817. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Clark, Tanya Williams can be contacted via phone (229) 248-2837.

Contact Information

Primary practice address
100 South West St. Bainbridge GA 39817
Fax: (229) 248-2844
Website:

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SLP004670 Georgia

Profile Details

NPI number 1518022425
LBN Legal business name Clark, Tanya Williams
Credentials CCC-SLP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 22nd, 2006
Last updated Jan 24th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518022425 NPPES
Georgia MEDICAID 000865664B

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