Individual
TAWNI WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., CCC/SLP
Contact information
Practice address
817 N HARPER ST, MONTGOMERY CITY, MO 63361-1513
(573) 564-3711
Mailing address
817 N HARPER ST, MONTGOMERY CITY, MO 63361-1513
(573) 564-3711
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2006020989
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
467434007
—
MO
Enumeration date
05/30/2007
Last updated
11/07/2018
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