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General NPI Number Information
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NPI Number | 1992415608
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Entity Type | Individual
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Provider Name | TIFFANY MARIE TARANTINO
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Gender | Female
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 12/05/2022
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Provider Practice Location Address
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Address Line | 1220 BROADCASTING RD STE 203
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City | WYOMISSING
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State | PA
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Zip | 19610-3221
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Country | US
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Telephone | 610-255-7997
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Fax | 610-214-2430
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Provider Business Mailing Address
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Address Line | 1220 BROADCASTING RD STE 203
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City | WYOMISSING
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State | PA
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Zip | 19610-3221
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Country | US
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Telephone | 610-255-7997
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Fax | 610-214-2430
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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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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number |
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Taxonomy #3
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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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