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General NPI Number Information
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NPI Number | 1932773504
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Entity Type | Individual
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Provider Name | TIFFANY A BIRT LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/18/2021
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Last Update Date | 10/14/2024
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Provider Practice Location Address
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Address Line | 10580 LIGON MILL RD STE 210
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City | WAKE FOREST
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State | NC
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Zip | 27587-6090
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Country | US
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Telephone | 919-263-0951
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Fax |
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Provider Business Mailing Address
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Address Line | 14409 HAMLETVILLE ST
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City | RALEIGH
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State | NC
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Zip | 27614-6621
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Country | US
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Telephone | 917-504-4979
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 12306A
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 01898
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License Number State | NC
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