Provider Demographics
NPI:1114121555
Name:OSBORNE, TIFFANY BRYANT (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:BRYANT
Last Name:OSBORNE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 ARDSLEY CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27407-7869
Mailing Address - Country:US
Mailing Address - Phone:336-202-6349
Mailing Address - Fax:
Practice Address - Street 1:400 VISION DR
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-3855
Practice Address - Country:US
Practice Address - Phone:336-672-5450
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist