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Individual

MRS. ERIN SIOBHAN TULLY-CLINARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MA, CCC-SLP

Contact information

Practice address
1220 DIVISION AVE, TACOMA, WA 98403-1321
(253) 403-4437
(253) 627-5004
Mailing address
31500 33RD PL SW APT Q103, FEDERAL WAY, WA 98023-5923
(253) 508-9394
(253) 627-5004

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
0000003121
TN
235Z00000X
Speech-Language Pathologist
Primary
LL00004323
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4106728
BCBS PROVIDER ID NUMBER
TN
Enumeration date
07/17/2006
Last updated
07/09/2007
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