Provider Demographics
NPI:1326202664
Name:HARVEY, TIFFANY L (AUD)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:L
Last Name:HARVEY
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 M STREET NW
Mailing Address - Street 2:SUITE #620
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1565
Mailing Address - Country:US
Mailing Address - Phone:202-785-8300
Mailing Address - Fax:202-785-5040
Practice Address - Street 1:2440 M ST NW
Practice Address - Street 2:SUITE #620
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1404
Practice Address - Country:US
Practice Address - Phone:202-785-8300
Practice Address - Fax:202-785-5040
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2201001367231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1326202664Medicaid
VA1326202664Medicaid