Provider Demographics
NPI:1225852312
Name:DYER, TIFFANY GAYLE (MS, LPC-C)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:GAYLE
Last Name:DYER
Suffix:
Gender:F
Credentials:MS, LPC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 NW 6TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1205
Mailing Address - Country:US
Mailing Address - Phone:405-609-3672
Mailing Address - Fax:
Practice Address - Street 1:721 NW 6TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73102-1205
Practice Address - Country:US
Practice Address - Phone:405-609-3672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKLPCCANDIDATE11909101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor