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General NPI Number Information
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NPI Number | 1689908865
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Entity Type | Individual
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Provider Name | TIFFANY ANN LEONE-VESPA PSY.D, LPC
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 02/23/2020
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Provider Practice Location Address
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Address Line | 663 N MAIN RD
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City | VINELAND
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State | NJ
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Zip | 08360-8204
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Country | US
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Telephone | 215-500-4924
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Fax |
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Provider Business Mailing Address
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Address Line | 3817 NATHAN LN
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City | VINELAND
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State | NJ
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Zip | 08361-7003
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC004103
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00365600
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License Number State | NJ
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