Provider Demographics
NPI:1952811606
Name:TIFFANY, SHEILA ANN (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:SHEILA
Middle Name:ANN
Last Name:TIFFANY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MRS
Other - First Name:SHEILA
Other - Middle Name:ANN
Other - Last Name:STAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:11520 CATHARPIN RD
Mailing Address - Street 2:
Mailing Address - City:SPOTSYLVANIA
Mailing Address - State:VA
Mailing Address - Zip Code:22553-3605
Mailing Address - Country:US
Mailing Address - Phone:540-785-8341
Mailing Address - Fax:
Practice Address - Street 1:11520 CATHARPIN RD
Practice Address - Street 2:
Practice Address - City:SPOTSYLVANIA
Practice Address - State:VA
Practice Address - Zip Code:22553-3605
Practice Address - Country:US
Practice Address - Phone:540-785-8341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202000248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist