Provider Demographics
NPI:1679074439
Name:SEMM, TIFFANY NOELLE (MST)
Entity Type:Individual
Prefix:MS
First Name:TIFFANY
Middle Name:NOELLE
Last Name:SEMM
Suffix:
Gender:F
Credentials:MST
Other - Prefix:MS
Other - First Name:TIFFANY
Other - Middle Name:NOELLE
Other - Last Name:KORFIKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:549 E 234TH ST APT 2K
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-2473
Mailing Address - Country:US
Mailing Address - Phone:303-667-8864
Mailing Address - Fax:
Practice Address - Street 1:549 E 234TH ST APT 2K
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-2473
Practice Address - Country:US
Practice Address - Phone:303-667-8864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-26
Last Update Date:2018-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst