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General NPI Number Information
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NPI Number | 1598800674
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Entity Type | Individual
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Provider Name | TIFFANY ANN WHITE CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1001 FLEET ST
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City | BALTIMORE
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State | MD
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Zip | 21202-4346
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Country | US
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Telephone | 800-627-4276
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Fax | 410-843-8441
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Provider Business Mailing Address
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Address Line | 6 WATERWAY CT APT 3D
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City | TOWSON
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State | MD
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Zip | 21286-4443
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Country | US
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Telephone | 410-610-1137
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 04891
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License Number State | MD
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