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General NPI Number Information
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NPI Number | 1689399784
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Entity Type | Individual
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Provider Name | TIFFANY DUNN MS,CCC/SLP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 804 EAST PINE
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City | EDGEWOOD
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State | TX
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Zip | 75117
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Country | US
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Telephone | 903-896-4332
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Fax | 903-896-4306
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Provider Business Mailing Address
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Address Line | 451 VZ COUNTY ROAD 4419
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City | BEN WHEELER
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State | TX
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Zip | 75754
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Country | US
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Telephone | 903-216-6020
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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 | 101114
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License Number State | TX
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