Individual
DR. TIFFANY S LEACH-BERTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
2001 LINCOLN DR W, SUITE E, MARLTON, NJ 08053-1531
(856) 596-9670
(856) 985-6302
Mailing address
8800 SE SUNNYSIDE RD STE 300N, CLACKAMAS, OR 97015-5703
(281) 286-2999
(512) 607-4893
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
41YA00073000
NJ
237600000X
Audiologist-Hearing Aid Fitter
Primary
YA730,MG949
NJ
237700000X
Hearing Instrument Specialist
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115350ZDHS
MEDICARE
NJ
Enumeration date
07/17/2007
Last updated
01/12/2018
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