Brakefield, Tiffany Amber
Brakefield, Tiffany Amber is an sole proprietor health care provider with primary practice located at 7309 Balmer St Bldg 545 , Hill Afb UT 84056. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Brakefield, Tiffany Amber can be contacted via phone (801) 777-7909.Contact Information
Primary practice address
7309 Balmer St Bldg 545
Hill Afb UT 84056
Phone: (801) 777-7909
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 0810004946 | Virginia |
Profile Details
| NPI number | 1811253222 |
|---|---|
| LBN Legal business name | Brakefield, Tiffany Amber |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 10th, 2012 |
| Last updated | Jun 12th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811253222 | NPPES |
| Virginia | Other | 810004946 | COMMONWEATH OF VIRGINIA |
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