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NPI Code Detail

MEDICARE: TIFFANY PARKES MOSCOVA

MEDICARE: TIFFANY PARKES MOSCOVA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker0906012520VA

General Provider Information

NPI Number : 1720745300
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY PARKES MOSCOVA
Provider Business Mailing Address
First Line : 10300 EATON PL STE 440
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-2239
Country : US
Telephone Number : 571-377-8218
Fax Number :
Provider Business Practice Location Address
First Line : 10300 EATON PL STE 440
Second Line :
City : FAIRFAX
State : VA
Zip : 22030-2239
Country : US
Telephone Number : 571-377-8218
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2021
Last Update Date : 02/21/2026

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Directions to “ TIFFANY PARKES MOSCOVA ” Practice Location

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