Provider Demographics
NPI:1730315219
Name:GUITREAU, TIFFANY A (LCSW)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:GUITREAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3837 PLAZA TOWER DR
Mailing Address - Street 2:STE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-4354
Mailing Address - Country:US
Mailing Address - Phone:225-810-3836
Mailing Address - Fax:225-810-3853
Practice Address - Street 1:3837 PLAZA TOWER DR
Practice Address - Street 2:STE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-4354
Practice Address - Country:US
Practice Address - Phone:225-810-3836
Practice Address - Fax:225-810-3853
Is Sole Proprietor?:No
Enumeration Date:2009-06-10
Last Update Date:2014-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
LA105751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker