Provider Demographics
NPI:1235563776
Name:SHERRED, TIFFANY R (NCSP)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:R
Last Name:SHERRED
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 SIMPSON DR
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3818
Mailing Address - Country:US
Mailing Address - Phone:724-469-3311
Mailing Address - Fax:
Practice Address - Street 1:100 SIMPSON DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3818
Practice Address - Country:US
Practice Address - Phone:724-469-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-01
Last Update Date:2013-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist