Provider Demographics
NPI:1952849259
Name:AMSLER, TIFFANY (M S, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:AMSLER
Suffix:
Gender:F
Credentials:M S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 STONERIDGE LN
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-1001
Mailing Address - Country:US
Mailing Address - Phone:405-200-3090
Mailing Address - Fax:
Practice Address - Street 1:326 N UNION AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-7053
Practice Address - Country:US
Practice Address - Phone:405-878-1051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist