Provider Demographics
NPI:1174869416
Name:FOY, TIFFANY ROSE (PSYD)
Entity type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:ROSE
Last Name:FOY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 E CARY ST
Mailing Address - Street 2:APT 525
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-7081
Mailing Address - Country:US
Mailing Address - Phone:631-935-4225
Mailing Address - Fax:
Practice Address - Street 1:798 SOUTHPARK BLVD
Practice Address - Street 2:SUITE 32
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-3615
Practice Address - Country:US
Practice Address - Phone:631-935-4225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-13
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810004682103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical