| Doctor Name: | MRS. TIFFANY DEMICHELE TEAMER |
| NPI Number: | 1104014182 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 079690 |
| Business Practice Address: | 223 Main St Astor Services For Children & Families Beacon, NY - 12508 |
| Business Phone Number: | 8458384920 |
| Business Fax Number: | 8458384924 |
| Mailing Address: | 17 Clark Hts, PLEASANT VALLEY |
| State: | NY |
| Postal Code: | 125697757 |
| Phone Number: | 8458384920 |
| Fax Number: | 8458384924 |
| NPI Enumeration Date: | 10/04/2007 |
| NPI Last Update Date: | 12/02/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 079690 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |