Provider Demographics
NPI:1942894910
Name:CLAY, TIFFANY (RBT)
Entity Type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:CLAY
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3403 JOHN TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAWN
Mailing Address - State:TN
Mailing Address - Zip Code:37191-8127
Mailing Address - Country:US
Mailing Address - Phone:931-237-3073
Mailing Address - Fax:
Practice Address - Street 1:3403 JOHN TAYLOR RD
Practice Address - Street 2:
Practice Address - City:WOODLAWN
Practice Address - State:TN
Practice Address - Zip Code:37191-8127
Practice Address - Country:US
Practice Address - Phone:931-237-3073
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-21
Last Update Date:2021-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician