Individual
TIFFANY PARKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
515 SIMPSON DR, WINONA, MS 38967-3009
(662) 508-5116
Mailing address
402B LEGACY PARK, RIDGELAND, MS 39157-4315
(769) 233-7154
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
05/13/2021
Last updated
05/13/2021
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