Provider Demographics
NPI:1225229628
Name:ACKLIN, TIFFANY LAMEIA
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LAMEIA
Last Name:ACKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 BATTLEMENT RD SW
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-3102
Mailing Address - Country:US
Mailing Address - Phone:256-353-0892
Mailing Address - Fax:
Practice Address - Street 1:9238 MADISON BLVD
Practice Address - Street 2:BLDG 1 SUITE 1300
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-9100
Practice Address - Country:US
Practice Address - Phone:256-774-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor