Provider Demographics
NPI:1740830223
Name:FORD, TIFFANY ANNE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:ANNE
Last Name:FORD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:ASHVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35953-4163
Mailing Address - Country:US
Mailing Address - Phone:256-613-5911
Mailing Address - Fax:
Practice Address - Street 1:3803 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:RAINBOW CITY
Practice Address - State:AL
Practice Address - Zip Code:35906-3025
Practice Address - Country:US
Practice Address - Phone:256-459-5051
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-16
Last Update Date:2019-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3183235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist