MEDICARE: HEATHER TINNIN MS CCC-SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1386372399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER TINNIN MS CCC-SLP

Provider Business Mailing Address
First Line	:	9703 STRATTON RIDGE DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-1640
Country	:	US
Telephone Number	:	281-797-1303
Fax Number	:

Provider Business Practice Location Address
First Line	:	9703 STRATTON RIDGE DR
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-1640
Country	:	US
Telephone Number	:	281-797-1303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	08/09/2022

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Directions to “ HEATHER TINNIN MS CCC-SLP” Practice Location

Language	Start Address	Practice Location

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