Individual
TIFFANY SAMUEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
415 N JACKSON ST, AMERICUS, GA 31709-3015
(229) 931-2470
Mailing address
519 W STEWART ST, QUITMAN, GA 31643-2647
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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