| Doctor Name: | TIFFANY SHEREE SHAW |
| NPI Number: | 1063649374 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC, NCC, LCAS |
| License Number: | 2075 |
| Business Practice Address: | 751 S Main St Suite 8 Raeford, NC - 283763258 |
| Business Phone Number: | 9102614635 |
| Business Fax Number: | |
| Mailing Address: | 946 Mockingbird Hill Rd, RAEFORD |
| State: | NC |
| Postal Code: | 283766363 |
| Phone Number: | 9102614635 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2009 |
| NPI Last Update Date: | 07/23/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 2075 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |