Provider Demographics
NPI:1821625807
Name:CRABTREE, TIFFANY JO (QMHS)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:JO
Last Name:CRABTREE
Suffix:
Gender:F
Credentials:QMHS
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:JO
Other - Last Name:LAWHORN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:QMHS
Mailing Address - Street 1:PO BOX 1507
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-1507
Mailing Address - Country:US
Mailing Address - Phone:740-354-7702
Mailing Address - Fax:740-353-6206
Practice Address - Street 1:901 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-3944
Practice Address - Country:US
Practice Address - Phone:740-354-7702
Practice Address - Fax:740-353-6206
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator