Individual
BRYAN KENNETH TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CCC-SLP
Contact information
Practice address
301 PERKINS DR., STE C, LAS CRUCES, NM 88005-3248
(575) 523-7243
(575) 525-5641
Mailing address
301 PERKINS DR., STE C, LAS CRUCES, NM 88005-3248
(575) 523-7243
(575) 525-5641
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2754
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09389334
—
NM
Enumeration date
11/17/2006
Last updated
03/10/2022
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