Healthcare Provider Details

I. General information

NPI: 1942755152
Provider Name (Legal Business Name): TIFFANY FORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2016
Last Update Date: 07/14/2025
Certification Date: 07/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1240 E PLEASANT RUN RD APT 1309
CEDAR HILL TX
75104-4127
US

IV. Provider business mailing address

1240 E PLEASANT RUN RD APT 1309
CEDAR HILL TX
75104-4127
US

V. Phone/Fax

Practice location:
  • Phone: 205-603-4022
  • Fax:
Mailing address:
  • Phone: 205-603-4022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number220008
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: