Provider Demographics
NPI:1336958891
Name:ELLIOT, TIFFANY (RBT)
Entity type:Individual
Prefix:MISS
First Name:TIFFANY
Middle Name:
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 N MAIN ST STE D203
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-6725
Mailing Address - Country:US
Mailing Address - Phone:781-267-0954
Mailing Address - Fax:781-885-0789
Practice Address - Street 1:500 N MAIN ST STE D203
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-6725
Practice Address - Country:US
Practice Address - Phone:781-267-0954
Practice Address - Fax:781-885-0789
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst