Doctor Name: | TIFFANY ANN BOSTER-POOR |
NPI Number: | 1801973375 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MED., CCC-SLP |
License Number: | 1971 |
Business Practice Address: | 15325 Poker Bend Rd Cameron, OK - 749322214 |
Business Phone Number: | 9186543379 |
Business Fax Number: | |
Mailing Address: | 15325 Poker Bend Rd, CAMERON |
State: | OK |
Postal Code: | 749322214 |
Phone Number: | 9186543379 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 1971 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | AR |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |