Provider Demographics
NPI:1053296913
Name:MEARS, TYJANEA JUDAH (MA, CF-SLP)
Entity type:Individual
Prefix:
First Name:TYJANEA
Middle Name:JUDAH
Last Name:MEARS
Suffix:
Gender:F
Credentials:MA, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 256
Mailing Address - Street 2:
Mailing Address - City:BLOXOM
Mailing Address - State:VA
Mailing Address - Zip Code:23308-0256
Mailing Address - Country:US
Mailing Address - Phone:757-710-5845
Mailing Address - Fax:
Practice Address - Street 1:2424 NORTHGATE DR STE 100
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-7888
Practice Address - Country:US
Practice Address - Phone:410-677-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-09
Last Update Date:2025-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist