Provider Demographics
NPI:1851533004
Name:ROBLEDO, TIFFANY C (SLP)
Entity type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:C
Last Name:ROBLEDO
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22665 S 194TH WAY
Mailing Address - Street 2:
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-8970
Mailing Address - Country:US
Mailing Address - Phone:480-390-8746
Mailing Address - Fax:
Practice Address - Street 1:3341 E QUEEN CREEK RD STE 109
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-8510
Practice Address - Country:US
Practice Address - Phone:480-390-8746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-02
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist