Provider Demographics
NPI:1023420734
Name:BREWER, TIFFANY DANIELLE (AUD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:DANIELLE
Last Name:BREWER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 BEVINS LN STE B
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-6145
Mailing Address - Country:US
Mailing Address - Phone:502-642-4322
Mailing Address - Fax:502-653-5116
Practice Address - Street 1:204 BEVINS LN STE B
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:KY
Practice Address - Zip Code:40324-6145
Practice Address - Country:US
Practice Address - Phone:502-642-4322
Practice Address - Fax:502-653-5116
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist