Provider Demographics
NPI:1326586892
Name:BARBER, TIFFANY MARIE
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:MARIE
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:MARIE
Other - Last Name:LARSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:378 HIGHLAND PINES RD
Mailing Address - Street 2:
Mailing Address - City:ROSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48654-9710
Mailing Address - Country:US
Mailing Address - Phone:989-889-9877
Mailing Address - Fax:
Practice Address - Street 1:378 HIGHLAND PINES RD
Practice Address - Street 2:
Practice Address - City:ROSE CITY
Practice Address - State:MI
Practice Address - Zip Code:48654-9710
Practice Address - Country:US
Practice Address - Phone:989-889-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-05
Last Update Date:2017-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator