● Active Type 1 · Individual

Tiffany Statham

Developmental Therapist·Pocatello, ID· NPI 1689553075 · Enumerated 2025 · 0 years on NPI

Statham is 1 of 10 developmental therapist providers in Pocatello and 1 of 162 in Idaho.

NPI age

— years

Enumerated 2025-08-29

Primary specialty

Developmental Therapist

Plus 1 subspecialty

Licensed in

—

0 states

Status

Active

No deactivations on record

Last NPPES update

2025-09-02

Source: monthly bulk 2026-05

Sole proprietor

Yes

Solo practice on file

How this provider compares

Across 162 active developmental therapist providers in Idaho.

NPI age

0 years

↓ 3 yr below median (3 yr)

State licenses

1 state

0% of peers hold multiple states

Subspecialties

In the 6% of peers with subspecialties

NPI lifetime · 2025 → 2026

2025-08Enumerated in NPPES

2025 2026

Where they practice

Practice location

737 W Whitman St

Pocatello, ID 832044203

📞 2082416456

Mailing address

737 W Whitman St

Pocatello, ID 832044203

📞 2082416456

Specialties

Respiratory, Developmental, Rehabilitative and Restorative Service Providers › Developmental Therapist

Developmental Therapist Primary

A Developmental Therapist is a person qualified by completion of an approved program in Developmental Therapy and where applicable credentialed by the state and practicing within the scope of the credential, or credentialed by...

taxonomy 222Q00000X
Behavior Technician

The behavior technician is a paraprofessional who practices under the close, ongoing supervision of a behavior analyst or assistant behavior analyst certified by the Behavior Analyst Certification Board and/or credentialed by a state...

taxonomy 106S00000X

Practice context

Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.

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How to verify this provider

Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
Check the state license is currently active.State licensing boards publish current status; NPPES does not.
Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.