Healthcare Provider Details

I. General information

NPI: 1578975496
Provider Name (Legal Business Name): TIFFANY BUCK M.S., BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TIFFANY BONDS M.S., BCBA, LBA

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11606 SOUTHFORK AVE STE 100
BATON ROUGE LA
70816-5235
US

IV. Provider business mailing address

1113 RANGE AVE STE 110-162
DENHAM SPRINGS LA
70726-4820
US

V. Phone/Fax

Practice location:
  • Phone: 225-747-0008
  • Fax:
Mailing address:
  • Phone: 225-747-0008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-10-7906
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: