Provider Demographics
NPI:1396168803
Name:BUSSON, TARYN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:TARYN
Middle Name:
Last Name:BUSSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:TARYN
Other - Middle Name:
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:412 DOGWOOD LN
Mailing Address - Street 2:WADSWORTH
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-1221
Mailing Address - Country:US
Mailing Address - Phone:330-590-0852
Mailing Address - Fax:
Practice Address - Street 1:144 N MARKET ST
Practice Address - Street 2:WOOSTER
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-4810
Practice Address - Country:US
Practice Address - Phone:330-988-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2014-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP. 10379235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist