Provider Demographics
NPI:1700666385
Name:MCCLAIN, IREION TIFFANY
Entity Type:Individual
Prefix:
First Name:IREION
Middle Name:TIFFANY
Last Name:MCCLAIN
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 1:2205 WILLIAMS TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4514
Mailing Address - Country:US
Mailing Address - Phone:281-305-0034
Mailing Address - Fax:
Practice Address - Street 1:2205 WILLIAMS TRACE BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4514
Practice Address - Country:US
Practice Address - Phone:281-305-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician