Provider Demographics
NPI:1245252337
Name:HANEY, TIFFANY SHEA (MS)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:SHEA
Last Name:HANEY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 BLUEWATER CT
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-3065
Mailing Address - Country:US
Mailing Address - Phone:404-321-6111
Mailing Address - Fax:404-728-5074
Practice Address - Street 1:1670 CLAIRMONT ROAD (ATLANTA)
Practice Address - Street 2:AUDIOLOGY AND SPEECH PATHOLOGY DEPARTMENT
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-728-5074
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD003645231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist