Doctor Name: | MS. TIFFANY MARIE MATSON |
NPI Number: | 1720255375 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S.W. |
License Number: | |
Business Practice Address: | 6301 Inducon Dr E Sanborn, NY - 141329014 |
Business Phone Number: | 7167312030 |
Business Fax Number: | |
Mailing Address: | 6301 Inducon Dr E, SANBORN |
State: | NY |
Postal Code: | 141329014 |
Phone Number: | 7167312030 |
Fax Number: | |
NPI Enumeration Date: | 05/13/2008 |
NPI Last Update Date: | 05/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |