Healthcare Provider Details

I. General information

NPI: 1578908166
Provider Name (Legal Business Name): TIFFANY SIOBHAN ANDERSON PSYD, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/08/2013
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3225 N POINT PKWY STE 201
ALPHARETTA GA
30005-4725
US

IV. Provider business mailing address

3225 N POINT PKWY STE 201
ALPHARETTA GA
30005-4725
US

V. Phone/Fax

Practice location:
  • Phone: 770-727-0244
  • Fax: 770-727-0134
Mailing address:
  • Phone: 770-727-0244
  • Fax: 770-727-0134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-20-46254
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY004716
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: