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General NPI Number Information
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NPI Number | 1740669415
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Entity Type | Individual
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Provider Name | TIFFANY M HUNTER M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 04/28/2023
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Provider Practice Location Address
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Address Line | 100 N MAIN ST
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City | SUFFOLK
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State | VA
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Zip | 23434-4529
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Country | US
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Telephone | 757-925-6764
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Fax | 757-925-5625
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Provider Business Mailing Address
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Address Line | 629 PHOENIX DR STE 115
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City | VIRGINIA BEACH
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State | VA
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Zip | 23452-7392
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Country | US
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Telephone | 757-261-4475
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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 | 2202007117
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License Number State | VA
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