Individual
TIFFANY MACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC-T
Contact information
Practice address
1463 FLATBUSH AVE, BROOKLYN, NY 11210-2428
(718) 951-9009
Mailing address
621 CRESCENT ST, BROOKLYN, NY 11208-3935
(718) 406-7075
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
33272
NY
Other
Enumeration date
12/04/2018
Last updated
12/04/2018
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