Provider Demographics
NPI:1184452500
Name:FORD, TIFFANY F
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:F
Last Name:FORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 UNDERHILL DR SE
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44646-7077
Mailing Address - Country:US
Mailing Address - Phone:234-224-2540
Mailing Address - Fax:
Practice Address - Street 1:437 UNDERHILL DR SE
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44646-7077
Practice Address - Country:US
Practice Address - Phone:234-650-2282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-25
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator