Provider Demographics
NPI:1063159366
Name:ADAMS-ROUSSELL, TIFFANY MARIE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MARIE
Last Name:ADAMS-ROUSSELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2756 LA 44
Mailing Address - Street 2:
Mailing Address - City:PAULINA
Mailing Address - State:LA
Mailing Address - Zip Code:70763-2602
Mailing Address - Country:US
Mailing Address - Phone:225-258-4700
Mailing Address - Fax:
Practice Address - Street 1:2756 LA 44
Practice Address - Street 2:
Practice Address - City:PAULINA
Practice Address - State:LA
Practice Address - Zip Code:70763-2602
Practice Address - Country:US
Practice Address - Phone:225-258-4700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA43752355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant