Provider Demographics
NPI:1902333230
Name:ONEAL, TIFFANY DENISE (BS, SLPA)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:DENISE
Last Name:ONEAL
Suffix:
Gender:F
Credentials:BS, SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6915 LAUREL BOWIE RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-1715
Mailing Address - Country:US
Mailing Address - Phone:240-245-4370
Mailing Address - Fax:
Practice Address - Street 1:6802 MCCLEAN BLVD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-7260
Practice Address - Country:US
Practice Address - Phone:410-444-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0061A2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant