Provider Demographics
NPI:1255891727
Name:LANG, TIFFANY JOY (HIS)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JOY
Last Name:LANG
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:MRS
Other - First Name:TIFFANY
Other - Middle Name:JOY
Other - Last Name:WING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4301 VINE ST
Mailing Address - Street 2:
Mailing Address - City:HAYS
Mailing Address - State:KS
Mailing Address - Zip Code:67601-9484
Mailing Address - Country:US
Mailing Address - Phone:785-628-3279
Mailing Address - Fax:785-628-3898
Practice Address - Street 1:4301 VINE ST
Practice Address - Street 2:
Practice Address - City:HAYS
Practice Address - State:KS
Practice Address - Zip Code:67601-9484
Practice Address - Country:US
Practice Address - Phone:785-628-3279
Practice Address - Fax:785-628-3898
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374J00000X
KS1637237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
No374J00000XNursing Service Related ProvidersDoula