Healthcare Provider Details

I. General information

NPI: 1043460348
Provider Name (Legal Business Name): HEATHER HOWELL TYLDESLEY MA, CCC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2008
Last Update Date: 08/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 SAINT VINCENTS DR POB#3 STE 402
BIRMINGHAM AL
35205-1606
US

IV. Provider business mailing address

833 SAINT VINCENTS DR POB#3 STE 402
BIRMINGHAM AL
35205-1606
US

V. Phone/Fax

Practice location:
  • Phone: 205-933-9236
  • Fax: 205-933-9213
Mailing address:
  • Phone: 205-933-9236
  • Fax: 205-933-9213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number938A
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number938A
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: