| Doctor Name: | DR. TIFFANY M BOARDS |
| NPI Number: | 1154619161 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D LLP |
| License Number: | 6301013175 |
| Business Practice Address: | 30200 Telegraph Rd Suite 402 Bingham Farms, MI - 480254502 |
| Business Phone Number: | 2486443200 |
| Business Fax Number: | 2486443211 |
| Mailing Address: | 30200 Telegraph Rd, Suite 402 BINGHAM FARMS |
| State: | MI |
| Postal Code: | 480254502 |
| Phone Number: | 2486443200 |
| Fax Number: | 2486443211 |
| NPI Enumeration Date: | 07/12/2011 |
| NPI Last Update Date: | 07/12/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | 6301013175 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |