Individual
TIFFANY S DOCTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
403 STONY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
(843) 761-7308
Mailing address
403 STONY LANDING RD, MONCKS CORNER, SC 29461-3967
(843) 761-8282
(843) 761-7308
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3348
MEDICARE PIN
SC
05
—
435201
—
SC
Enumeration date
07/31/2017
Last updated
07/21/2022
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