Tiffany Scavo Bright, CCC-SLP

Individual provider Active NPI Speech-Language Pathologist · Perry, GA

NPI 1013229830 · NPPES record last updated Nov 8, 2013

Key facts

NPI
1013229830
Entity type
Individual (NPI type 1)
Primary specialty
Speech-Language Pathologist 235Z00000X
License
SLP007042 (GA)
Practice address
902 Northside Dr
Perry, GA 31069-3344
Phone
(478) 987-1610
Fax
(973) 965-4580
NPI assigned
Jul 9, 2010
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
SLP007042GAMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SLP007042 GA Yes

Addresses

Primary practice location

902 Northside Dr
Perry, GA 31069-3344

Mailing address

902 Northside Dr
Perry, GA 31069-3344
Phone (478) 987-1610

Other identifiers

IdentifierTypeStateIssuer
003105610AMedicaidGA

Other names

  • Tiffany Marie Scavo Former name

Other providers in Perry, GA

All providers in Perry, GA · Speech-Language Pathologist in Georgia

Sources for this page

Verify at the official NPI Registry.