Individual
TIFFANY PAGE COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5011 ARBUTUS AVE, BALTIMORE, MD 21215-5723
(443) 759-8921
Mailing address
2208 KOKO LN, BALTIMORE, MD 21216-2926
(301) 800-1478
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
01706-24-A
MD
175T00000X
Peer Specialist
Primary
PR1218
MD
251B00000X
Case Management Agency
—
—
Other
Enumeration date
07/29/2024
Last updated
11/01/2025
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