Provider Demographics
NPI:1073858999
Name:BARNETT, TIFFANY TIERRA (LLBSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:TIERRA
Last Name:BARNETT
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:TIERRA
Other - Last Name:DAWKINS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LLBSW
Mailing Address - Street 1:500 HANCOCK ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4224
Mailing Address - Country:US
Mailing Address - Phone:989-797-3400
Mailing Address - Fax:989-799-0206
Practice Address - Street 1:500 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4224
Practice Address - Country:US
Practice Address - Phone:989-797-3400
Practice Address - Fax:989-799-0206
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
MI6802088417171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator