Provider Demographics
NPI:1437337912
Name:BEARD, TIFFINNY ODELL
Entity Type:Individual
Prefix:
First Name:TIFFINNY
Middle Name:ODELL
Last Name:BEARD
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 1:17630 WAYFOREST DR
Mailing Address - Street 2:281
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060
Mailing Address - Country:US
Mailing Address - Phone:832-909-9445
Mailing Address - Fax:
Practice Address - Street 1:17630 WAYFOREST DR
Practice Address - Street 2:CONDO 281
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-7000
Practice Address - Country:US
Practice Address - Phone:832-909-9445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)