Provider Demographics
NPI:1710365846
Name:WILLIAMS, TIFFANY JOANN (MA COUNSELING)
Entity Type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:JOANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA COUNSELING
Other - Prefix:MISS
Other - First Name:TIFFANY
Other - Middle Name:JOANN
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:205 PEARL CIR FLORENCE
Mailing Address - Street 2:
Mailing Address - City:SC
Mailing Address - State:SC
Mailing Address - Zip Code:29506
Mailing Address - Country:US
Mailing Address - Phone:843-260-9530
Mailing Address - Fax:
Practice Address - Street 1:205 PEARL CIR FLORENCE
Practice Address - Street 2:
Practice Address - City:SC
Practice Address - State:SC
Practice Address - Zip Code:29506
Practice Address - Country:US
Practice Address - Phone:843-260-9530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-08
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)