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General NPI Number Information
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NPI Number | 1326580499
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Entity Type | Individual
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Provider Name | CLAIRE TATUM
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Gender | Female
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 01/03/2025
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Provider Practice Location Address
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Address Line | 6030 VILLAGE DR STE 100
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City | LINCOLN
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State | NE
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Zip | 68516-4773
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Country | US
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Telephone | 402-484-0326
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Fax |
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Provider Business Mailing Address
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Address Line | 118 HERRON ST
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City | FORT OGLETHORPE
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State | GA
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Zip | 30742-3126
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Country | US
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Telephone | 706-861-7471
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Fax | 706-861-7472
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | PCET002445
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License Number State | GA
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