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General NPI Number Information
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NPI Number | 1871127514
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Entity Type | Individual
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Provider Name | TIFFANI DICKERSON RN-IBCLC
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Gender | Female
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Dates
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Enumeration Date | 03/02/2020
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 1636 N HAMPTON RD STE 227
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City | DESOTO
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State | TX
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Zip | 75115-8601
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Country | US
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Telephone | 972-765-8195
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Fax |
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Provider Business Mailing Address
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Address Line | 1636 N HAMPTON RD STE 227
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City | DESOTO
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State | TX
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Zip | 75115-8601
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Country | US
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Telephone | 972-765-8195
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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 | 374J00000X
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Taxonomy Name | Doula
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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 | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 764609
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License Number State | TX
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