Healthcare Provider Details

I. General information

NPI: 1245719848
Provider Name (Legal Business Name): TIFFANY SLAGER CD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/14/2018
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4943 BARNUM ST
SEBRING FL
33876-5681
US

IV. Provider business mailing address

4943 BARNUM ST
SEBRING FL
33876-5681
US

V. Phone/Fax

Practice location:
  • Phone: 186-338-1719
  • Fax:
Mailing address:
  • Phone: 863-381-7199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: