Provider Demographics
NPI:1063183093
Name:BIGELOW, TIFFANY LYNN
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LYNN
Last Name:BIGELOW
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 1:9607 EMPRESS CROSSING DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-6691
Mailing Address - Country:US
Mailing Address - Phone:713-306-0066
Mailing Address - Fax:
Practice Address - Street 1:3840 BRIARCHASE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77014-2755
Practice Address - Country:US
Practice Address - Phone:281-891-8465
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102169235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist