Healthcare Provider Details

I. General information

NPI: 1285119594
Provider Name (Legal Business Name): TIFFANY J SMITH-MORPHIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

344 FAYETTEVILLE AVE
ALMA AR
72921-3655
US

IV. Provider business mailing address

344 FAYETTEVILLE AVE
ALMA AR
72921-3655
US

V. Phone/Fax

Practice location:
  • Phone: 479-632-4600
  • Fax:
Mailing address:
  • Phone: 479-632-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: