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Individual

TANNER S KING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.S. CCC-SLP

Contact information

Practice address
2151 OLD ROCKY RIDGE RD, VESTAVIA HILLS, AL 35216-7235
(205) 583-2883
Mailing address
2151 OLD ROCKY RIDGE RD, VESTAVIA HILLS, AL 35216-7235

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5276
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8317490
DRIVER'S LICENSE
AL
Enumeration date
02/23/2023
Last updated
02/23/2023
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