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General NPI Number Information
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NPI Number | 1730095910
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Entity Type | Individual
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Provider Name | TIFFANY PRATCHER
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Gender | Female
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 970 SWINNEA RDG STE 1
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City | SOUTHAVEN
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State | MS
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Zip | 38671-6037
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Country | US
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Telephone | 901-677-3405
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Fax | 901-441-8920
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Provider Business Mailing Address
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Address Line | 970 SWINNEA RDG STE 1
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City | SOUTHAVEN
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State | MS
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Zip | 38671-6037
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Country | US
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Telephone | 901-677-3405
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Fax | 901-441-8920
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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 | M9589
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License Number State | MS
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