Provider Demographics
NPI:1467964379
Name:HOPKINS, TIFFANY (PHD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:ANN
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:361 THE GREENS CIR APT 244
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-5259
Mailing Address - Country:US
Mailing Address - Phone:561-312-1661
Mailing Address - Fax:
Practice Address - Street 1:361 THE GREENS CIR APT 244
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-5259
Practice Address - Country:US
Practice Address - Phone:561-312-1661
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-01
Last Update Date:2017-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5266103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical