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General NPI Number Information
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NPI Number | 1851203665
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Entity Type | Individual
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Provider Name | TIFFANY PETERS LMSW
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Gender | Female
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Dates
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Enumeration Date | 09/18/2026
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Last Update Date | 09/18/2026
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Provider Practice Location Address
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Address Line | 15480 THREE OAKS RD
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City | THREE OAKS
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State | MI
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Zip | 49128-9545
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Country | US
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Telephone | 931-538-2213
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Fax |
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Provider Business Mailing Address
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Address Line | 301 E INDIANA AVE
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City | THREE OAKS
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State | MI
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Zip | 49128-1305
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6801122319
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License Number State | MI
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