Provider Demographics
NPI:1376782417
Name:PRISKA, TIFFANY AMBER (MA, LPC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:AMBER
Last Name:PRISKA
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17510 HUFFMEISTER RD
Mailing Address - Street 2:STE. 104
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6785
Mailing Address - Country:US
Mailing Address - Phone:832-741-7389
Mailing Address - Fax:
Practice Address - Street 1:17510 HUFFMEISTER
Practice Address - Street 2:STE. 104
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429
Practice Address - Country:US
Practice Address - Phone:832-741-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62861101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional