Small-Burnam, Tawny Crystal
Small-Burnam, Tawny Crystal is an sole proprietor health care provider with primary practice located at 6886 Main St Ste 1B2 Box 4, Lithonia GA 30058-4508. 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. Small-Burnam, Tawny Crystal can be contacted via phone (770) 367-4241.Contact Information
Primary practice address
6886 Main St Ste 1B2 Box 4
Lithonia GA 30058-4508
Phone: (770) 367-4241
Fax: (770) 482-9401
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP005983 | Georgia |
Profile Details
| NPI number | 1376747428 |
|---|---|
| LBN Legal business name | Small-Burnam, Tawny Crystal |
| Credentials | SLP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 13th, 2007 |
| Last updated | Nov 30th, 2010 - about 15 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376747428 | NPPES |
| Georgia | Other | 051314571 | DRIVERS LICENSE |
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