Provider Demographics
NPI:1124375142
Name:CINELLI, TIFFANY LYN (BS, CTCM)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:LYN
Last Name:CINELLI
Suffix:
Gender:F
Credentials:BS, CTCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 WILMETTE AVE APT 803
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-9517
Mailing Address - Country:US
Mailing Address - Phone:386-235-2526
Mailing Address - Fax:
Practice Address - Street 1:160 N BEACH ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3314
Practice Address - Country:US
Practice Address - Phone:386-235-2526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator