Individual
TIFFANY PERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
2362 MAIN ST STE B, TUCKER, GA 30084-4477
(770) 939-5800
Mailing address
2362 MAIN ST STE B, TUCKER, GA 30084-4477
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
MSW006632
GA
101YM0800X
Mental Health Counselor
MSW006632
GA
101YP2500X
Professional Counselor
MSW006632
GA
104100000X
Social Worker
MSW006632
GA
Other
Enumeration date
04/16/2015
Last updated
04/17/2015
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