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General NPI Number Information
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NPI Number | 1780916239
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Entity Type | Individual
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Provider Name | TIFFANY HENLEY
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Gender | Female
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Dates
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Enumeration Date | 02/09/2010
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Last Update Date | 09/25/2025
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Provider Practice Location Address
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Address Line | 1501 N CLASSEN BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73106-6611
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Country | US
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Telephone | 405-595-2716
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Fax | 405-235-5671
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Provider Business Mailing Address
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Address Line | 2040 E MEMORIAL RD APT 24
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City | EDMOND
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State | OK
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Zip | 73013-5515
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Country | US
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Telephone | 405-706-9799
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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 | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State | OK
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Taxonomy #2
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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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