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General NPI Number Information
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NPI Number | 1013692540
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Entity Type | Individual
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Provider Name | TIFFANY MARIE STEPHENS TLBA
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Gender | Female
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Dates
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Enumeration Date | 06/21/2023
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Last Update Date | 05/05/2025
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Provider Practice Location Address
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Address Line | 1011 N HIGHWAY 27
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City | WHITLEY CITY
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State | KY
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Zip | 42653-5025
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Country | US
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Telephone | 606-516-4665
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Fax |
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Provider Business Mailing Address
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Address Line | 574 MEADOWS GROVE RD
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City | PINE KNOT
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State | KY
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Zip | 42635-9152
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Country | US
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Telephone | 606-516-4665
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 285356
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 298761
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License Number State | KY
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