Provider Demographics
NPI:1164950002
Name:WASHINGTON, TIFFANY JUANITA (RBT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JUANITA
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 GOLDEN EAGLE CT
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-3557
Mailing Address - Country:US
Mailing Address - Phone:916-524-3810
Mailing Address - Fax:
Practice Address - Street 1:1205 GOLDEN EAGLE CT
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-3557
Practice Address - Country:US
Practice Address - Phone:916-524-3810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist