Provider Demographics
NPI:1962668871
Name:KRUM, AMY LYNN TRIBBLE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:LYNN TRIBBLE
Last Name:KRUM
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:AMY
Other - Middle Name:LYNN
Other - Last Name:TRIBBLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CCC-SLP
Mailing Address - Street 1:1 PEACHTREE DR
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-1200
Mailing Address - Country:US
Mailing Address - Phone:912-925-4402
Mailing Address - Fax:912-920-4756
Practice Address - Street 1:11800 ABERCORN ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-1908
Practice Address - Country:US
Practice Address - Phone:912-925-4402
Practice Address - Fax:912-920-4756
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP006880235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist