Individual
MRS. TIFFANY NICOLE THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
508 NORTH TRUMAN BLVD, UPPER LEVEL J, CRYSTAL CITY, MO 63019
(636) 524-3895
(636) 931-1961
Mailing address
909 WINSTON CT, HILLSBORO, MO 63050
(636) 524-3895
(636) 931-1961
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
01/31/2012
Last updated
02/21/2014
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