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General NPI Number Information
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NPI Number | 1659928588
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Entity Type | Individual
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Provider Name | TIFFANY MANNING
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Gender | Female
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Dates
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Enumeration Date | 08/26/2019
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 909 GREENLEE ST
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City | DENTON
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State | TX
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Zip | 76201-7064
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Country | US
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Telephone | 940-382-5112
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Fax |
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Provider Business Mailing Address
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Address Line | 2061 KENNY CT
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City | LEWISVILLE
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State | TX
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Zip | 75067-6178
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Country | US
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Telephone | 916-717-8046
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 88820
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License Number State | CA
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