Provider Demographics
NPI:1306431028
Name:TRUELOVE, TIFFANY LOUANN
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:LOUANN
Last Name:TRUELOVE
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 1:126 S CENTER AVE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-8000
Mailing Address - Country:US
Mailing Address - Phone:405-432-2844
Mailing Address - Fax:
Practice Address - Street 1:126 S CENTER AVE
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-8000
Practice Address - Country:US
Practice Address - Phone:405-585-8345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)