Individual
TIFFANY HADDOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
12000 MARKET ST APT 403, RESTON, VA 20190-6203
(703) 346-2168
Mailing address
12000 MARKET ST APT 403, RESTON, VA 20190-6203
(703) 346-2168
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0701002866
VA
Other
Enumeration date
12/20/2020
Last updated
12/20/2020
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