Provider Demographics
NPI:1497072771
Name:BOATRIGHT, TIFFANY MICHELLE (MA)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:MICHELLE
Last Name:BOATRIGHT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
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Mailing Address - Street 1:100 S MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-5369
Mailing Address - Country:US
Mailing Address - Phone:918-423-3700
Mailing Address - Fax:918-423-3712
Practice Address - Street 1:100 S MAIN ST
Practice Address - Street 2:SUITE B
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-5369
Practice Address - Country:US
Practice Address - Phone:918-423-3700
Practice Address - Fax:918-423-3712
Is Sole Proprietor?:No
Enumeration Date:2010-04-27
Last Update Date:2010-04-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health