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General NPI Number Information
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NPI Number | 1669052783
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Entity Type | Individual
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Provider Name | TIFFANY ANDERSEN MS
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Gender | Female
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 1493 CAMBRIDGE ST RM 239
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City | CAMBRIDGE
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State | MA
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Zip | 02139-1099
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Country | US
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Telephone | 617-575-5399
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Fax |
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Provider Business Mailing Address
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Address Line | 7 TIMBERWOOD DR UNIT 311
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City | LEBANON
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State | NH
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Zip | 03766-4474
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Country | US
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Telephone |
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY10000414
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License Number State | MA
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