| Doctor Name: | MRS. TIFFANY MARIE BABCOCK |
| NPI Number: | 1124142807 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CADC,QHEIC |
| License Number: | |
| Business Practice Address: | 2323 Windish Dr Galesburg, IL - 614019780 |
| Business Phone Number: | 3093444233 |
| Business Fax Number: | 3093444281 |
| Mailing Address: | Po Box 105, ROSEVILLE |
| State: | IL |
| Postal Code: | 614730105 |
| Phone Number: | 3197504886 |
| Fax Number: | |
| NPI Enumeration Date: | 03/19/2007 |
| NPI Last Update Date: | 04/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |