Provider Demographics
NPI:1194183848
Name:TIGHE, COLLEEN LYNN (MS SLP-CF)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:LYNN
Last Name:TIGHE
Suffix:
Gender:F
Credentials:MS SLP-CF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4914 SUNWAY LN
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NY
Mailing Address - Zip Code:14075-2336
Mailing Address - Country:US
Mailing Address - Phone:716-648-3651
Mailing Address - Fax:
Practice Address - Street 1:150 STAHL RD
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1231
Practice Address - Country:US
Practice Address - Phone:716-629-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY956158151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist