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Individual
TIFFANY DELORES BASKETT
Active
Individual
TIFFANY DELORES BASKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAS-A
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
NULL
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LCAS-27501
NC
172V00000X
Community Health Worker
—
NULL
Other
Enumeration date
09/30/2020
Last updated
06/27/2023
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