Tullis, Tishunda Johnson

Tullis, Tishunda Johnson is an individual health care provider with primary practice located at 1801 S 23Rd St Ste 2 , Fort Pierce FL 34950-4830. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Tullis, Tishunda Johnson can be contacted via phone (772) 464-3303.

Contact Information

Primary practice address
1801 S 23Rd St Ste 2 Fort Pierce FL 34950-4830
Phone: (772) 464-3303
Fax: (772) 464-3305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Speech-Language Pathologist 235Z00000X SA5222 Florida

Profile Details

NPI number 1881721314
LBN Legal business name Tullis, Tishunda Johnson
Credentials M.S., CCC-SLP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2007
Last updated Nov 6th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881721314 NPPES
Florida MEDICAID 014022400
Florida MEDICAID 885794600

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