Provider Demographics
NPI:1518251669
Name:HAGAN, TIFFINY HARRIS
Entity type:Individual
Prefix:
First Name:TIFFINY
Middle Name:HARRIS
Last Name:HAGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFINY
Other - Middle Name:
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:42465 HIGHWAY 195
Mailing Address - Street 2:
Mailing Address - City:HALEYVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35565-7052
Mailing Address - Country:US
Mailing Address - Phone:256-350-1764
Mailing Address - Fax:
Practice Address - Street 1:1510 N BRINDLEE MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:ARAB
Practice Address - State:AL
Practice Address - Zip Code:35016-5723
Practice Address - Country:US
Practice Address - Phone:256-931-2013
Practice Address - Fax:256-931-2014
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3149235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist