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Individual

TABITHA RUTH SYME

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS CF SLP

Contact information

Practice address
1106 SW 4TH AVE, ONTARIO, OR 97914-2130
(541) 216-5115
Mailing address
500 E GALLOWAY AVE, WEISER, ID 83672-1422
(206) 931-4796

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16932
BOARD OF EXAMINERS FOR SPEECH-LANGUAGE PATHOLOGY & AUDIOLOGY: STATE LICENSE
OR
Enumeration date
09/03/2020
Last updated
09/03/2020
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