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Individual
MRS. TIFFANY MORRIS SCANDRETT
Active
Individual
MRS. TIFFANY MORRIS SCANDRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP005793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
167270852A
—
GA
01
—
20-0847484
TAX IDENTIFICATION NUMBER
GA
01
—
305467
WELLCARE PROVIDER ID
GA
Enumeration date
11/13/2006
Last updated
07/20/2011
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