Provider Demographics
NPI:1689957813
Name:TALIAFERRO, TIFFANY JONAY (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:JONAY
Last Name:TALIAFERRO
Suffix:
Gender:F
Credentials:MA, 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:PO BOX 1360
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832
Mailing Address - Country:US
Mailing Address - Phone:301-774-0052
Mailing Address - Fax:
Practice Address - Street 1:3423 OLNEY LAYTONSVILLE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1787
Practice Address - Country:US
Practice Address - Phone:301-774-0052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06656235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist