Individual
TIFFANY ROOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D., LP, LSSP
Contact information
Practice address
6001 SUMMERSIDE DR STE 202, DALLAS, TX 75252-5336
(608) 577-8420
Mailing address
6001 SUMMERSIDE DR STE 202, DALLAS, TX 75252-5336
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
39458
TX
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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