MEDICARE: TRESSA EVANHOE M.S. CF-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	TSLP11976	AZ

General Provider Information

NPI Number	:	1760037923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRESSA EVANHOE M.S. CF-SLP

Provider Business Mailing Address
First Line	:	4101 W HARDY RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4101 W HARDY RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8917
Country	:	US
Telephone Number	:	520-579-4600
Fax Number	:

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

Provider Enumeration Date	:	08/05/2019
Last Update Date	:	08/05/2019

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Directions to “ TRESSA EVANHOE M.S. CF-SLP” Practice Location

Language	Start Address	Practice Location

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