Individual
MISS DOREEN ANNE TIERNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
35 STATE AVE, FARIBAULT, MN 55021-6368
(507) 497-3790
Mailing address
35 STATE AVE STE 2, FARIBAULT, MN 55021-6369
(507) 497-3790
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
003440
CT
235Z00000X
Speech-Language Pathologist
6195
MA
235Z00000X
Speech-Language Pathologist
Primary
SP00543
RI
Other
Enumeration date
03/20/2007
Last updated
04/02/2020
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