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General NPI Number Information
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NPI Number | 1821119876
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Entity Type | Individual
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Provider Name | TIFFANY DAWN SIMPSON PSYD
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Gender | Female
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 04/20/2022
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Provider Practice Location Address
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Address Line | 13 FORGA PLAZA LOOP
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City | WAYNESVILLE
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State | NC
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Zip | 28786-1932
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Country | US
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Telephone | 219-689-7632
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Fax |
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Provider Business Mailing Address
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Address Line | 368 TANNER TRL
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City | WAYNESVILLE
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State | NC
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Zip | 28785-8203
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Country | US
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Telephone | 219-689-7632
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 20042274A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | NC5167
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License Number State | NC
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