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Individual

MRS. DAWN ELIZABETH TALLENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA CCC-SLP

Contact information

Practice address
1132 ELMONT RD, SULLIVAN, MO 63080-1039
(573) 468-5171
Mailing address
36 MIMOSA LN, SULLIVAN, MO 63080-3012
(573) 259-4970

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2012026104
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
M465038917
MO
Enumeration date
08/14/2017
Last updated
08/14/2017
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