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Individual
MS. AMY C TYNER
Active
Individual
MS. AMY C TYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA3653
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
113991
AMERIGROUP
FL
01
—
11982201
CITRUS HEALTHCARE
FL
01
—
244
ATA
FL
01
—
672202496
MEDWAIVER
FL
05
—
883059200
—
FL
01
—
S2869
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/10/2006
Last updated
06/20/2016
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