Provider Demographics
NPI:1033450572
Name:MAHER, TIFFANY TERE' (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:TERE'
Last Name:MAHER
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 1:8157 WOODLAND CT
Mailing Address - Street 2:
Mailing Address - City:DUNN LORING
Mailing Address - State:VA
Mailing Address - Zip Code:22027-1207
Mailing Address - Country:US
Mailing Address - Phone:703-217-0372
Mailing Address - Fax:
Practice Address - Street 1:8157 WOODLAND CT
Practice Address - Street 2:
Practice Address - City:DUNN LORING
Practice Address - State:VA
Practice Address - Zip Code:22027-1207
Practice Address - Country:US
Practice Address - Phone:703-204-1838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202004444235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist