MEDICARE: TANIYA JIWANI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1801538582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANIYA JIWANI

Provider Business Mailing Address
First Line	:	2011 HAMMONDS FERRY RD
Second Line	:
City	:	HALETHORPE
State	:	MD
Zip	:	21227-1721
Country	:	US
Telephone Number	:	678-314-1745
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 HAMMONDS FERRY RD
Second Line	:
City	:	HALETHORPE
State	:	MD
Zip	:	21227-1721
Country	:	US
Telephone Number	:	678-314-1745
Fax Number	:

Authorized Official
Title or Position	:	SPEECH PATHOLOGIST
Name	:	TANIYA JIWANI
Credential	:	M.S., CCC-SLP
Telephone Number	:	678-314-1745

Provider Enumeration Date	:	04/12/2022
Last Update Date	:	04/12/2022

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Language	Start Address	Practice Location

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