Provider Demographics
NPI:1992821987
Name:HAWKINS-HALL, TIFFANY DEANNE (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:DEANNE
Last Name:HAWKINS-HALL
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BASTROP
Mailing Address - State:LA
Mailing Address - Zip Code:71220-5915
Mailing Address - Country:US
Mailing Address - Phone:225-273-9708
Mailing Address - Fax:318-641-2301
Practice Address - Street 1:1510 ELM ST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:LA
Practice Address - Zip Code:71220-5915
Practice Address - Country:US
Practice Address - Phone:225-588-7505
Practice Address - Fax:833-466-1805
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4627235Z00000X
LA12103667373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist