| Doctor Name: | TIFFANY MESSICK BOLLINGER |
| NPI Number: | 1063732485 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW |
| License Number: | 6409387-3502 |
| Business Practice Address: | 9263 Redwood Rd Building 8 Ste B West Jordan, UT - 840886571 |
| Business Phone Number: | 8015660749 |
| Business Fax Number: | 8015667108 |
| Mailing Address: | 117 Calbourne Ln, I-1 SANDY |
| State: | UT |
| Postal Code: | 840702085 |
| Phone Number: | 8018601666 |
| Fax Number: | |
| NPI Enumeration Date: | 06/08/2010 |
| NPI Last Update Date: | 06/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 6409387-3502 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | UT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |