Provider Demographics
NPI:1487926358
Name:CHAMBERS, TIFFANY A
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:A
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 S BELL BLVD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3972
Mailing Address - Country:US
Mailing Address - Phone:512-925-6030
Mailing Address - Fax:512-428-8143
Practice Address - Street 1:930 S BELL BLVD
Practice Address - Street 2:SUITE 404
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3972
Practice Address - Country:US
Practice Address - Phone:512-925-6030
Practice Address - Fax:512-428-8143
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-07
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65273101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor