Provider Demographics
NPI:1457004582
Name:TAYLOR, TIFFANY SINCLAIR (RCSWI)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:SINCLAIR
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26829 TANIC DR STE 101
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544-4612
Mailing Address - Country:US
Mailing Address - Phone:813-994-4440
Mailing Address - Fax:813-973-1254
Practice Address - Street 1:26829 TANIC DR STE 101
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544-4612
Practice Address - Country:US
Practice Address - Phone:813-994-4440
Practice Address - Fax:813-973-1254
Is Sole Proprietor?:No
Enumeration Date:2022-01-29
Last Update Date:2022-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW130371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical