Provider Demographics
NPI:1710120860
Name:TWINING, TIMOTHY JAY (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:JAY
Last Name:TWINING
Suffix:
Gender:M
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8301 SYLVAN WOODS DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-2933
Mailing Address - Country:US
Mailing Address - Phone:941-284-5632
Mailing Address - Fax:
Practice Address - Street 1:8301 SYLVAN WOODS DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34243-2933
Practice Address - Country:US
Practice Address - Phone:941-284-5632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-18
Last Update Date:2009-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 2969235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist