Individual
TIFFANY NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, CCC-SLP
Contact information
Practice address
6330 W THUNDERBIRD RD, GLENDALE, AZ 85306-4002
(623) 486-6000
Mailing address
2426 W WHITE FEATHER LN, PHOENIX, AZ 85085-4794
(860) 944-0056
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP11151
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SLP11151
—
AZ
Enumeration date
08/13/2018
Last updated
08/13/2018
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