Provider Demographics
NPI:1578055794
Name:PASKETT, TIFFANY MURILLO (ACMHC)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MURILLO
Last Name:PASKETT
Suffix:
Gender:F
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10808 S RIVER FRONT PKWY STE 361
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-6300
Mailing Address - Country:US
Mailing Address - Phone:760-440-8433
Mailing Address - Fax:
Practice Address - Street 1:10808 S RIVER FRONT PKWY STE 361
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-6300
Practice Address - Country:US
Practice Address - Phone:760-440-8433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-04
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health