Provider Demographics
NPI:1770267882
Name:PAILIN, TIARRA B (LSW)
Entity type:Individual
Prefix:
First Name:TIARRA
Middle Name:B
Last Name:PAILIN
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21153 E 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80249-7035
Mailing Address - Country:US
Mailing Address - Phone:720-276-2368
Mailing Address - Fax:
Practice Address - Street 1:21153 E 47TH AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80249-7035
Practice Address - Country:US
Practice Address - Phone:720-276-2368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO.0009924116104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker