EDWENA RAYLENE TUCKER (NPI# 1255531299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255531299 |
| Entity Type | Individual |
| Full Name | EDWENA RAYLENE TUCKER |
| Credential | S.L.P. |
| Practice Address |
2300 Gravel Dr Fort Worth TX 76118-6950 |
| Mailing Address |
6737 Riviera Dr Fort Worth TX 76180-8121 |
| Practice Telephone | 8175897033 |
| Mailing Telephone | 8174987118 |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2007-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 235Z00000X | Speech-Language Pathologist | 10546 | TX | Speech, Language and Hearing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS | 85064T | 01 |
| Street Address |
2300 GRAVEL DR |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76118-6950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699896183 | Tamara Michelle Young | Occupational Therapist | 2300 Gravel Dr, Fort Worth, TX 76118-6950 | 2007-04-02 |
| 1528189024 | Virginia Kathleen Fincher | Physical Therapist | 2300 Gravel Dr, Fort Worth, TX 76118-6950 | 2007-04-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619475936 | Ellen Dixon | Specialist/Technologist | 9502 Garden Wood Drive Apt 421, Fort Worth, TX 76118 | 2018-02-01 |
| 1588016067 | Bartholomew Henderson | Registered Nurse | 3604 Scranton Dr, Richland Hills, TX 76118 | 2016-07-07 |
| 1447548391 | Brent Cooper Orr | Technician, Other | 7415 Whitehall Street Suite 118, Ft Worth, TX 76118 | 2011-07-13 |
| 1972804300 | National Hme | Durable Medical Equipment & Medical Supplies | 7451 Airport Freeway, Richland Hills, TX 76118 | 2010-11-17 |
| 1053572628 | C3 Christian Academy LLC | Respite Care | 6609 Baker Blvd, Richland Hills, TX 76118 | 2008-06-17 |
| 1922282946 | C3 Academy, LLC | Custodial Care Facility | 6609 Baker Blvd., Richland Hills, TX 76118 | 2007-12-27 |
| 1770787202 | George L Ruffin | Counselor | 6900 Boulevard 26, Richland Hills, TX 76118 | 2007-06-11 |
| 1649322629 | Bestcare Home Health,inc | Home Health | 7215-a Baker Blvd., Richland Hills, TX 76118 | 2007-01-18 |
| 1972692838 | Clearview Medical Incorporated | Durable Medical Equipment & Medical Supplies | 2503 Gravel Dr, Fort Worth, TX 76118 | 2006-10-11 |
| 1790753689 | Breath of Life, Inc. | Durable Medical Equipment & Medical Supplies | 2612 Gravel Dr, Bldg 7, Fort Worth, TX 76118 | 2006-03-08 |
| Find all providers in zip 76118 | ||||
| Taxonomy Code | 235Z00000X |
| Grouping | Speech, Language and Hearing Service Providers |
| Classification | Speech-Language Pathologist |
| The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. |
| Notes: "Scope of Practice in Speech-Language Pathology", American Speech-Language-Hearing Association, 2013. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770142 | Kaitlyn Hazlewood | Speech-Language Pathologist | 7204 Ellis Rd, Fort Worth, TX 76112-4302 | 2020-11-03 |
| 1174134696 | Meagan Reyneveld | Speech-Language Pathologist | 405 Crawford St Apt 2330, Fort Worth, TX 76104-1395 | 2020-08-10 |
| 1639794902 | Sarah Mayorga | Speech-Language Pathologist | 3645 Gray St Apt 1209, Fort Worth, TX 76177-1721 | 2020-06-12 |
| 1417579558 | Fort Worth Children's Speech and Feeding Therapy, Pllc | Speech-Language Pathologist | 3631 S Hills Ave, Fort Worth, TX 76109-2754 | 2020-05-12 |
| 1518588201 | Korynn Apodaca | Speech-Language Pathologist | 704 Dale Ln Apt 124, Fort Worth, TX 76108-2659 | 2020-05-04 |
| 1487288544 | Robert J Wincowski | Speech-Language Pathologist | 6913 Camp Bowie Blvd Ste 121, Fort Worth, TX 76116-7164 | 2020-02-27 |
| 1154952687 | Shelby Reed | Speech-Language Pathologist | 411 Harrold St Apt 1273, Fort Worth, TX 76107-3141 | 2020-02-03 |
| 1114562857 | Hilary Byatt | Speech-Language Pathologist | 10357 Alta Vista Rd Unit 351, Fort Worth, TX 76244-6559 | 2019-11-15 |
| 1104468156 | Marianne Brawner | Speech-Language Pathologist | 4216 Sarita Dr, Fort Worth, TX 76109-4746 | 2019-10-10 |
| 1801444005 | Kristin Kirkley | Speech-Language Pathologist | 1604 Dakar Rd W, Fort Worth, TX 76116-1818 | 2019-08-30 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76118 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.