Individual
ALYSSA TATUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1826 FAIRFAX AVE APT 1, CINCINNATI, OH 45207
(937) 760-0289
Mailing address
1826 FAIRFAX AVE APT 1, CINCINNATI, OH 45207-1812
(937) 760-0289
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP.12610
OH
Other
Enumeration date
08/08/2016
Last updated
08/12/2018
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