Provider Demographics
NPI:1194480772
Name:SEABROOKS, TIFFANY MICHELE
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:MICHELE
Last Name:SEABROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39280 PUEBLO DR
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:MI
Mailing Address - Zip Code:48174-5021
Mailing Address - Country:US
Mailing Address - Phone:989-355-5511
Mailing Address - Fax:
Practice Address - Street 1:39280 PUEBLO DR
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:MI
Practice Address - Zip Code:48174-5021
Practice Address - Country:US
Practice Address - Phone:989-355-5511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker