Provider Demographics
NPI:1801538582
Name:TANIYA JIWANI
Entity type:Organization
Organization Name:TANIYA JIWANI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:TANIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JIWANI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:678-314-1745
Mailing Address - Street 1:2011 HAMMONDS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:HALETHORPE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1721
Mailing Address - Country:US
Mailing Address - Phone:678-314-1745
Mailing Address - Fax:
Practice Address - Street 1:2011 HAMMONDS FERRY RD
Practice Address - Street 2:
Practice Address - City:HALETHORPE
Practice Address - State:MD
Practice Address - Zip Code:21227-1721
Practice Address - Country:US
Practice Address - Phone:678-314-1745
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty