Provider Demographics
NPI:1821119876
Name:SIMPSON, TIFFANY DAWN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:DAWN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:368 TANNER TRL
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28785-8203
Mailing Address - Country:US
Mailing Address - Phone:219-689-7632
Mailing Address - Fax:
Practice Address - Street 1:13 FORGA PLAZA LOOP
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-1932
Practice Address - Country:US
Practice Address - Phone:219-689-7632
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20042274A103T00000X
NCNC5167103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist