Moore, Tiffany

Moore, Tiffany is an sole proprietor health care provider with primary practice located at 600 Lake Hollingsworth Dr , Lakeland FL 33803-2364. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Behavioral Health & Social Service Providers / Assistant Behavior Analyst. Behavioral Health & Social Service Providers / Assistant Behavior Analyst is her primary health care specialty. Moore, Tiffany can be contacted via phone (863) 665-7300.

Contact Information

Primary practice address
600 Lake Hollingsworth Dr Lakeland FL 33803-2364
Phone: (863) 665-7300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X RBT-18-49175 Florida
Behavioral Health & Social Service Providers / Assistant Behavior Analyst 106E00000X

Profile Details

NPI number 1083114698
LBN Legal business name Moore, Tiffany
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 20th, 2018
Last updated May 26th, 2022 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1083114698 NPPES
Florida MEDICAID 019102000

Popular Providers