Provider Demographics
NPI:1861120602
Name:CAVALIER, TIFFANY LANDRY (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LANDRY
Last Name:CAVALIER
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4204 AUGUSTA PL
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-2919
Mailing Address - Country:US
Mailing Address - Phone:504-400-1162
Mailing Address - Fax:
Practice Address - Street 1:800 FOX AVE
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4552
Practice Address - Country:US
Practice Address - Phone:463-713-5992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102382235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist