Basic Information
| Provider Information | |||||||||
| NPI: | 1679726699 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | TIFFANY | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | MS, CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1916 MAHONE CT | ||||||||
| Address2: | |||||||||
| City: | DANIEL ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294927977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8642051410 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3971 LITTLE SAVANNAH RD | ||||||||
| Address2: | STE 132 | ||||||||
| City: | CULLOWHEE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287235804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282277251 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2008 | ||||||||
| LastUpdateDate: | 09/18/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174N00000X | N | Other Service Providers | Lactation Consultant, Non-RN | 235Z00000X | 2692 | SC | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.