Healthcare Provider Details

I. General information

NPI: 1689208746
Provider Name (Legal Business Name): TIFFANIE ALEXANDER RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5033 GEORGE WASHINGTON MEM HWY
YORKTOWN VA
23692-2510
US

IV. Provider business mailing address

714 HEMLOCK AVE
HAMPTON VA
23661-1732
US

V. Phone/Fax

Practice location:
  • Phone: 631-901-3711
  • Fax:
Mailing address:
  • Phone: 786-399-5823
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: