Individual
DR. TIFFANY FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LCAS-A
Contact information
Practice address
25350 US HIGHWAY 19 N, #286, CLEARWATER, FL 33763-2146
(919) 633-3797
Mailing address
25350 US HIGHWAY 19 N, #286, CLEARWATER, FL 33763-2146
(919) 633-3797
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
2868-A
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12449225
CAQH
NC
Enumeration date
05/24/2012
Last updated
10/11/2012
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