Doctor Name: | TIFFANY BUSSIERE |
NPI Number: | 1023414075 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SAS2397 |
Business Practice Address: | 155 Kennedy Memorial Dr Waterville, ME - 049015132 |
Business Phone Number: | 2078725775 |
Business Fax Number: | 2078726116 |
Mailing Address: | Po Box 257, WATERVILLE |
State: | ME |
Postal Code: | 049030257 |
Phone Number: | 2078725775 |
Fax Number: | 2078726116 |
NPI Enumeration Date: | 11/18/2014 |
NPI Last Update Date: | 01/04/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2355S0801X |
License Number: | SAS2397 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ME |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Specialist/Technologist |
Taxonomy Specialization: | Speech-Language Assistant |
Taxonomy Definition: |