Individual
TIFFANY P COLLINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ADMINISTRATOR
Contact information
Practice address
135 E WARREN AVE, BROOKHAVEN, MS 39601-4146
(601) 919-6294
(866) 982-3424
Mailing address
2982 JAMES DR NW, WESSON, MS 39191-9613
(601) 919-6294
(866) 982-3424
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
—
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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