Provider Demographics
NPI:1780045054
Name:SEICK, TIFFANY MARIE (CPHT)
Entity Type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:MARIE
Last Name:SEICK
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 FALCON CREEK WAY
Mailing Address - Street 2:APT 302
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-0608
Mailing Address - Country:US
Mailing Address - Phone:513-849-0655
Mailing Address - Fax:
Practice Address - Street 1:4901 FALCON CREEK WAY
Practice Address - Street 2:APT 302
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-0608
Practice Address - Country:US
Practice Address - Phone:513-849-0655
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-15
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0230027765247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other