Provider Demographics
NPI:1710212097
Name:WAYMAN, TIFFANY E (LMSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:E
Last Name:WAYMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W 139TH ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10037-1538
Mailing Address - Country:US
Mailing Address - Phone:347-209-1445
Mailing Address - Fax:
Practice Address - Street 1:50 W 139TH ST APT 2L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1538
Practice Address - Country:US
Practice Address - Phone:347-209-1445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2009-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker