Provider Demographics
NPI:1942393285
Name:INDIERO, TIFFANY BRIDIS (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:BRIDIS
Last Name:INDIERO
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:MISS
Other - First Name:TIFFANY
Other - Middle Name:SUE
Other - Last Name:BRIDIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS
Mailing Address - Street 1:16807 GENTLE STONE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5120
Mailing Address - Country:US
Mailing Address - Phone:281-859-2269
Mailing Address - Fax:
Practice Address - Street 1:10804 HUFFMEISTER RD
Practice Address - Street 2:SUITE D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3177
Practice Address - Country:US
Practice Address - Phone:281-477-9500
Practice Address - Fax:281-477-9563
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102483235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist