Provider Demographics
NPI:1356045769
Name:CASH, TIFFANY ANDREA
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:ANDREA
Last Name:CASH
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 1:6200 SUMMERSWEET DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2634
Mailing Address - Country:US
Mailing Address - Phone:202-486-7435
Mailing Address - Fax:
Practice Address - Street 1:6200 SUMMERSWEET DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-2634
Practice Address - Country:US
Practice Address - Phone:202-486-7435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-29
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10273594375106S00000X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician