MEDICARE: MRS. TAMMY GWEN DRURY M.A.,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	116552	MO

General Provider Information

NPI Number	:	1598819245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TAMMY GWEN DRURY M.A.,CCC-SLP

Provider Business Mailing Address
First Line	:	6276 COUNTY ROAD 313
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-8446
Country	:	US
Telephone Number	:	573-243-9004
Fax Number	:

Provider Business Practice Location Address
First Line	:	6276 COUNTY ROAD 313
Second Line	:
City	:	CAPE GIRARDEAU
State	:	MO
Zip	:	63701-8446
Country	:	US
Telephone Number	:	573-243-9004
Fax Number	:

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

Provider Enumeration Date	:	01/22/2007
Last Update Date	:	07/09/2007

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Directions to “ MRS. TAMMY GWEN DRURY M.A.,CCC-SLP” Practice Location

Language	Start Address	Practice Location

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