Healthcare Provider Details

I. General information

NPI: 1821419896
Provider Name (Legal Business Name): TIFFANY SHANETTE MSAFIRI PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 01/03/2022
Certification Date: 01/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3011 AKRON RD
WOOSTER OH
44691-7904
US

IV. Provider business mailing address

101 PEMBROKE CT
GREENSBURG PA
15601-6404
US

V. Phone/Fax

Practice location:
  • Phone: 330-202-3809
  • Fax:
Mailing address:
  • Phone: 724-396-1510
  • Fax: 724-972-4627

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1000627
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: