Provider Demographics
NPI:1578975496
Name:BONDS CAVER, TIFFANY (MS, BCBA)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:
Last Name:BONDS CAVER
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4283 FABER RD
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-7725
Mailing Address - Country:US
Mailing Address - Phone:901-496-1878
Mailing Address - Fax:
Practice Address - Street 1:4283 FABER RD
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-7725
Practice Address - Country:US
Practice Address - Phone:901-496-1878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-27
Last Update Date:2014-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-10-7906103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst