Provider Demographics
NPI:1588805972
Name:TIMM, TIFFANY DANIELLE (BA, RC)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:DANIELLE
Last Name:TIMM
Suffix:
Gender:F
Credentials:BA, RC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 S DIVISION ST
Mailing Address - Street 2:SPOKANE MENTAL HEALTH
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-1510
Mailing Address - Country:US
Mailing Address - Phone:509-838-4651
Mailing Address - Fax:
Practice Address - Street 1:131 S DIVISION ST
Practice Address - Street 2:SPOKANE MENTAL HEALTH
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1510
Practice Address - Country:US
Practice Address - Phone:509-838-4651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00055334101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional