Provider Demographics
NPI:1902193923
Name:HAWKINS, TIFFANY M (SLP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:M
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:M
Other - Last Name:REMINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:655 NORTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8740
Mailing Address - Country:US
Mailing Address - Phone:570-842-9323
Mailing Address - Fax:570-842-9362
Practice Address - Street 1:24569 ROUTE 6
Practice Address - Street 2:SUITE C
Practice Address - City:TOWANDA
Practice Address - State:PA
Practice Address - Zip Code:18848-8254
Practice Address - Country:US
Practice Address - Phone:570-265-7688
Practice Address - Fax:570-265-7422
Is Sole Proprietor?:No
Enumeration Date:2011-06-29
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL010871235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist