Tullis, Tishunda Johnson
Tullis, Tishunda Johnson is an individual health care provider with primary practice located at 1801 S 23Rd St Ste 2 , Fort Pierce FL 34950-4830. 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. Tullis, Tishunda Johnson can be contacted via phone (772) 464-3303.Contact Information
Primary practice address
1801 S 23Rd St Ste 2
Fort Pierce FL 34950-4830
Phone: (772) 464-3303
Fax: (772) 464-3305
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SA5222 | Florida |
Profile Details
NPI number | 1881721314 |
---|---|
LBN Legal business name | Tullis, Tishunda Johnson |
Credentials | M.S., CCC-SLP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Feb 28th, 2007 |
Last updated | Nov 6th, 2020 - about 5 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 | 1881721314 | NPPES |
Florida | MEDICAID | 014022400 | |
Florida | MEDICAID | 885794600 |
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