Individual
MAE ROSE TYSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CF-SLP
Contact information
Practice address
3630 NORTHBROOK DR STE D, NORTHPORT, AL 35473-5804
(205) 246-9345
(949) 862-5156
Mailing address
3100 GUILFORD RD, MOUNTAIN BRK, AL 35223-1217
(205) 936-9893
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
200081
AL
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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