Provider Demographics
NPI:1114331956
Name:INMAN, TIFFANY (AUD, CCC-A F-AAA)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:INMAN
Suffix:
Gender:F
Credentials:AUD, CCC-A F-AAA
Other - Prefix:DR
Other - First Name:TIFFANY
Other - Middle Name:
Other - Last Name:SEXTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, F-AAA
Mailing Address - Street 1:1635 W BIG BEAVER RD
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3501
Mailing Address - Country:US
Mailing Address - Phone:248-839-5439
Mailing Address - Fax:248-244-8604
Practice Address - Street 1:1635 W BIG BEAVER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3501
Practice Address - Country:US
Practice Address - Phone:248-839-5439
Practice Address - Fax:248-244-8604
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2020-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000681231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1114331956Medicaid