Healthcare Provider Details

I. General information

NPI: 1568621738
Provider Name (Legal Business Name): TIFFANY ANN STRAZZE CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 02/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PILLSBURY ST SUITE #404
CONCORD NH
03301-3523
US

IV. Provider business mailing address

1465 HOOKSETT RD UNIT 303
HOOKSETT NH
03106-1831
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-7827
  • Fax: 603-228-7828
Mailing address:
  • Phone: 603-608-9295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1126
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: