Healthcare Provider Details

I. General information

NPI: 1710227764
Provider Name (Legal Business Name): TASHA LEANN ROWELL M.S., CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2013
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CREAX RD
AXIS AL
36505-4710
US

IV. Provider business mailing address

3663B CELESTE OAKS DR
SARALAND AL
36571-8819
US

V. Phone/Fax

Practice location:
  • Phone: 251-554-9596
  • Fax:
Mailing address:
  • Phone: 251-554-9596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number3076
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: