Provider Demographics
NPI:1518383371
Name:MORGAN, TIFFANIE NICOLE (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANIE
Middle Name:NICOLE
Last Name:MORGAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:TIFFANIE
Other - Middle Name:NICOLE
Other - Last Name:KLEMENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:5724 NORTHFIELD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-3750
Mailing Address - Country:US
Mailing Address - Phone:940-634-7126
Mailing Address - Fax:
Practice Address - Street 1:4901 BRYANT IRVIN RD N
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107
Practice Address - Country:US
Practice Address - Phone:817-738-9866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-17
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106649235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist