Organization
TIFFANY HOLLAND, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLT DAVIS (CREDENTIALING SPECIALISTS)
(912) 484-3879
Entity
Organization
Contact information
Practice address
80 LADYS ISLAND DR, BEAUFORT, SC 29907-1643
(843) 476-7421
Mailing address
PO BOX 846, SAINT HELENA ISLAND, SC 29920-0846
(843) 476-7421
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5480
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PC1361
—
SC
Enumeration date
04/15/2016
Last updated
04/15/2016
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